全胸腔镜二尖瓣成形术的应用及发展现状

Application and development of totally thoracoscopic mitral valve plasty

从20世纪90年代开始胸腔镜微创技术被逐渐应用于二尖瓣成形术。全胸腔镜二尖瓣成形术具有创伤小、切口美观、术后恢复快等优点,受到广大患者及心脏外科医生的青睐。但目前国内全胸腔镜二尖瓣手术的占比仍然较低。全胸腔镜二尖瓣成形术在适应人群、围手术期并发症和远期预后等方面仍存在争议;另外技术难度高、外科医生培养周期长也限制了该技术的普及。本文通过总结现有文献资料,分析与传统正中开胸二尖瓣成形术相比,全胸腔镜二尖瓣成形术的应用现状。

Thoracoscopic minimally invasive technology has been used in mitral valve plasty since 1990s. Totally thoracoscopic mitral valve plasty has the advantages of small trauma, beautiful incision and rapid postoperative recovery.It is favored by more and more patients and cardiac surgeons. However, according to the reports, the proportion of totally thoracoscopic mitral valve surgery in China is still low. Mitral valve plasty via the totally thoracoscopic approach is still controversial in terms of population adaptation, perioperative complications and long-term prognosis. In addition, the technical difficulty and the long training cycle of surgeons also limit the popularization of this technology. By summarizing the existing literature, this paper analyzes the application and development of totally thoracoscopic approach in comparison with the traditional median thoracotomy mitral valve plasty.