Clinical Analysis And Comparative Study Of Thoracoscopic And Traditional Thoracotomy For Mitral Valve Disease

Objective:To compare totally thoracoscopic surgery and traditional median sternotomy corresponding to the difference in two groups of patients undergoing postoperative follow-up and implementation of the relevant information at the time of mitral valve replacement or mitral valve repair,explore assisted thoracic surgery in mitral valve replacement or mitral valve repair,the advantages and disadvantages and clinical value.Methods:A retrospective study of 36 patients with simple mitral valve disease from November 2017 to October 2018 in our hospital for cardiothoracic surgery was performed by physical examination,chest X-ray,ECG,and CT.Fifty patients underwent thoracoscopic mitral valve replacement or orthopedic surgery as a complete thoracoscopic group;18 patients underwent conventional median thoracotomy or valvuloplasty as a control group.The data of intraoperative,postopera-tive and follow-up data of these two groups were statistically analyzed.The prognosis of the two procedures in mitral valve treatment and the advantages and disadvantages of the surgical plan was systematically evaluated,thus providing a more scientific clinical treatment.guidance.RESULTS:(1)Intraoperative observations: duration of extracorporeal circulation,duration of aortic occlusion,and operative time,the complete thoracoscopic group was inferior to the traditional median open chest group(P < 0.05);(2)postoperative Observed indicators: postoperative assisted breathing duration,24 h chest drainage,ICU stay time,hospital stay,red blood cell transfusion volume,VAS score on the first day,the total thoracoscopic group was lower than the traditional median thoracotomy group(P < 0.05)However,the medical cost was higher than that of the traditional median thoracotomy group(P < 0.05).There was no significant difference in myocardial enzymes and residual shunt between the two groups(P > 0.05).(3)Postoperativecomplications: two groups There were no significant differences in new-onset atrial fibrillation,stroke,pulmonary infection,acute renal failure,chylothorax,and hospital mortality(P > 0.05),whereas the rate of poor wound healing in the complete thoracoscopic group was significantly lower than that in the traditional mid-center.The thoracic surgery group;(4)The results of the SF-12 questionnaire showed that there was significant difference in the quality of life between the complete thoracoscopic group and the traditional median thoracotomy group at 1 month and 3months(P > 0.05).Conclusion:Complete thoracoscopic mitral valve surgery has no increase in postoperative complication rate.It is as safe and feasible as traditional thoracotomy.The clinical effect of minimally invasive thoracoscopic mitral valve surgery is more significant;complete Patients in the thoracoscopic group recovered quickly after surgery,and there was difference in the postoperative quality of life between the patients in the traditional middle chest group.