Clinical Outcome Of Thoracoscopic Vsd Closure Versus Conventional Median Sternotomy
Ikromzhon Ismanovich Mukhamedov, Dr., Seitkhan Joshibayev, Prof., Zhalil Sheishenov, Julia Ukolova, Azamat Kenbayev, Dr., Guldana Poshakaeva, Dr., Zafar Rozbayev, Dr., Almaz Alibekov, Dr., Gali Iskakbayev.
Research-Clinical Center for Cardiac Surgery and Transplantology, Taraz, Kazakhstan.
ЗАДНИЙ ПЛАН: Comparison of the results of closure of the ventricular septal defect using thoracoscopic and median approaches
доступов МЕТОДЫ:Between 2012 and 2021, 59 patients with ventricular septal defects were divided into two groups: thoracoscopic group (n-27) and conventional median sternotomy group (n-32). In the thoracoscopic group, all patients underwent total endoscopic procedures with peripheral cardiopulmonary bypass, whereas in the conventional group, all patients were operated using conventional median sternotomy approach. The average age of patients in thoracoscopic group was 12 (8-20) years, in conventional group was 13 (9-22) yearsРЕЗУЛЬТАТЫ: VSD closure was overall successful and there were no in-hospital mortality in both groups. Duration of intensive care in thoracoscopic group was 16 (14-18) vs. 21 (19-22) hrs (p <0,001) in conventional method. Mechanical ventilation time were 105 (70-115) vs 180 (135-218) minutes (p<0,001), whereas volumes of operational bleeding were 170 (120-190) vs 190 (140-250) ml (p<0,027) and duration of post-operative hospital stay were 7 (6-8) vs. 8 (7-9) days (p <0,001) in thoracoscopic and conventional group, respectively. However, the total duration of operation was longer in thoracoscopic group 256±26 (246-2670) minutes than in the conventional group 211±42 (195-226) minutes (p<0,001). The cardiopulmonary bypass time was longer in the thoracoscopic group than in the conventional group (94 (73-110) min and 57 (44-68) min, respectively) (p<0,001). The postoperative scar in thoracoscopic group was significantly smaller in size (p<0.001) than one in the conventional group (50 (42-55) mm and 150 (128-180) mm, respectivelyCONCLUSIONS:The data obtained indicate the successful use of two approaches, however, in the group where thoracoscopic correction was performed, duration of stay in the ICU and in the hospital, volume of blood loss, the need for blood transfusion, and the length of the skin incision were significantly lower than in the group of the median sternotomy access
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