A Comparative Study Of The Right Thoracic Minimally Invasive Incision And Conventional Thoracic Incision Left Atrial Myxoma Removal

Purpose:Comparison of right thoracic minimally invasive incision with the traditional thoracic incision left atrial myxoma removal of the safety and clinical efficacy.Methods:Select from July 2011 to February 2017,Jilin University,Second Hospital of Cardiovascular Surgery performed right minimally invasive incision left atrial myxoma removal of 39 patients as a incision group,the same period of 30 cases of traditional thoracic incision Left atrial myxoma patients as a control group.A total of 39 patients with left atrial myxoma in the small incision group were diagnosed as left atrial myxoma disease according to the history,specialist examination and cardiac echocardiography.Among them,the simple left atrial myxoma in 17 cases,combined with mitral regurgitation in 6 cases,combined with tricuspid regurgitation in 6 cases,with mitral and tricuspid regurgitation in 10 cases.There were 14 cases of simple left atrial myxoma in the control group,combined with mitral regurgitation in 5 cases,combined with tricuspid regurgitation in 4 cases,with mitral valve And tricuspid regurgitation in 7 cases.The time of hospitalization,the time of aorta occlusion,the time of operation,the time of operation,the time of mechanical ventilation,the time of ICU stay,the time of 24 h drainage,the rate of hemodialysis,the amount of blood transfusion,Activity time,length of stay and postoperative complications.Postoperative 6 months,1 year,3 year outpatient and / or telephone follow-up.The data were analyzed by SPSS 19.0 software.The measurement data were expressed by (?).The two groups were compared by independent t test.The count data (were expressed as the number of cases(%),and the X~2 test was used between the two groups.P <0.05 for the difference was statistically significant.Results:All patients were successfully completed the operation,intraoperative removal of pathological examination results were confirmed as myxoma,two groups were no deaths during perioperative period.In the small incision group,the incision length(4-6)cm,mean(5.2 ± 1.2)cm.The time of aorta occlusion,transit time and operation time were longer in the small incision group than in the control group(P> 0.05).The time of postoperative mechanical ventilation,ICU residence time,postoperative 24 h drainage,secondary thoracic hemostasis,postoperative blood transfusion,downtime and hospital stay were statistically significant(P < 0.05).Small incision group and control group were postoperative renal failure,other important organ failure,nervous system and other complications.Small incision group 1 case of incision fat liquefaction,after dressing healing,and the control group 1 case of mediastinal infection,after debridement suture healing.And the two groups of patients after 6 months,1 year,3 years follow-up results,follow-up period,small incision group were no death,no recurrence,cardiac function were significantly improved.Conculsions:The use of right minimally invasive small incision left atrial myxoma removal of safe and feasible,the exact effect,and has obvious advantages,it is worth promoting.