全胸腔镜下房间隔缺损手术治疗的临床效果OA

Objective To investigate the surgical effect of totally thoracoscopic surgery for atrial septal defect(ASD).Methods A total of 104 ASD patients who underwent ASD repair at our hospital between July 2022 to July 2023 were enrolled and divided into two groups based on the surgical approach:the endoscopic group(Group A,n=52)and the traditional thora-cotomy group(Group B,n=52).Parameters compared included cardiopulmonary bypass(CPB)time,aortic cross-clamp time,24 hours thoracic drainage volume,ventilator support time,ICU stay time,postoperative hospital stay,total hospitalization cost,blood salvaged volume,incidence of complications,rate of re-sternotomy for bleeding,rate of spontaneous sinus rhythm resump-tion,and follow-up results.Results All patients successfully underwent ASD repair ASD repair combined with tricuspid val-vuloplasty,or ASD repair combined with patent foramen ovale closure.Spontaneous resumption of sinus rhythm occurred after aortic unclamping in all patients across both groups.No severe complications were observed,all patients were discharged cured,and no re-sternotomy for bleeding was required.In group A,no procedures required extended incisions or conversion to median sternotomy.However,two patients in group A had residual leakage of about 2mm and were discharged for observation without treatment.There was no statistical difference in the general preoperative data between the two groups(P>0.05).Compared with the conventional thoracotomy group,the endoscopic group demonstrated significantly longer CPB and aortic cross-clamp time,higher hospitalization costs,significantly less 24h drainage flow volume,and a shorter postoperative hospital stay(P<0.05).There was no significant difference between the two groups in postoperative ventilator support time,ICU time,blood salvaged volume,rate of rethoracotomy for bleeding rate of spontaneous rhythm resumption,or incidence of complications(P>0.05).Conclusion Totally complete thoracoscopic ASD surgery is safe and feasible,offering advantages such as minimal invasiveness and faster postoperative recovery.