A Single Port Thoracoscope,Right Lateral Minithoracotomy And Traditional Thoracotomy In The Treatment Of Congenital Heart Disease

Objective: to summarize the surgical experience by comparing and analyzing the clinical data of single operation hole thoracoscopic heart beating,right lateral minithoracotomy beating heart and traditional surgery in the treatment of congenital heart disease.at the same time,to explore the safety,feasibility and minimally invasive value of single-hole thoracoscopic beating heart surgery and right lateral minithoracotomy beating heart surgery in the treatment of congenital heart disease.Methods: the surgical data of 89 patients with CHD in the Department of Cardiac surgery of the first affiliated Hospital of Bengbu Medical College from September 2015 to December 2019 were collected and divided into three groups according to single operation hole thoracoscopic heart beating,right lateral minithoracotomy beating heart and traditional operation.Routine group(n = 33),right chest group(n = 30)and thoracoscopy group(n = 26).The statistical indexes of the three groups included: cardiopulmonary bypass time,aortic cross-clamping time,superior and inferior vena cava occlusion time,operation time,intraoperative blood transfusion volume,postoperative observation index: ventilator-assisted time,ICU time,postoperative hospital stay,postoperative 24-hour drainage,postoperative complications.The collected data were compared and analyzed after statistical processing.Results: there was no death in the three groups,and all the patients were cured and discharged from hospital.In terms of operation time,cardiopulmonary bypass time and superior and inferior vena cava blocking time,the right chest group was significantly better than the routine group and thoracoscopic group.In terms of blood transfusion volume,the amount of blood transfusion was the least in the thoracoscopic group and the most in the routine group.In terms of ventilator assist time,the right chest group and thoracoscopy group were significantly better than the conventional group;in terms of postoperative drainage 24 hours,the thoracoscopic group was the least and the conventional group was the most;in terms of ICU time,the thoracoscopic group was significantly better than the conventional group and the right chest group;in terms of postoperative hospital stay,the routine group was the longest and the thoracoscopic group was the shortest.During the follow-up of 2 ～ 5 years,no residual shunt,obvious valvular insufficiency and late death were found in the three groups.Conclusion: single operation hole thoracoscopic beating heart surgery and right lateral minithoracotomy beating heart surgery can not only reduce surgical trauma and bring cosmetic effect,but also reduce surgical trauma and bring cosmetic effect.they are two safe and feasible minimally invasive surgical methods.compared with right lateral minithoracotomy beating heart surgery,single operation hole thoracoscopic beating heart surgery has better minimally invasive and cosmetic effect.