右腋下小切口入路矫治法洛四联症253例

Correction of Tetralogy of Fallot through Right Subaxillary Mini-incision Approach ： Clinical Analysis of 253 Cases

目的：总结经右腋下小切口入路矫治法洛四联症253例的手术方法及临床疗效。方法：经右腋下小切口入路矫治法洛四联症253例（R组），并与同期经正中入路根治的法洛四联症210例（C组）作对照观察。结果：R组和C组术中体外循环时间、主动脉阻断时间、呼吸机辅助时间、手术死亡率和主要并发症发生率的比较，差异均有统计学意义（P〉0．05）。24h引流量R组少于C组（P〈0．05）。结论：右腋下小切口入路矫治法洛四联症具有损伤小、疤痕隐蔽、不破坏胸骨完整性、能预防正中开胸后术后鸡胸等特点，能满足大部分法洛四联症手术矫治的需要。

Objective：To summarize the experience of anatomic correction of 253 patients with Tetralogy of Fallot （TOF） by fight minimal thoracotomy. Methods ：253 patients with TOF received correction by fight minimal thoracotomy （group R）, whose clinical data were retrospectively analyzed. In the same period, Other 210 patients with TOF, who accepted radical correction through a middlemost approach, served as control group （ group C ）. Results ： There was not statistical difference between group R and C in consuming times of cardiopulmonary bypass, aortic clamping and mechanical ventilation, operative mortality and incidence of main complications （ P 〉 0.05 ）. The draining volume during the first 24 h in group R was less than that in group C （ P 〈 0.05 ）. Conclusions ： The right minimal thoracotomy has advantages of less damage, inconspicuous scar, remaining sternal intcgrality, preventing occurrence of pigeon breast following the thoracotomy through a middlemost approach. This operative approach could meet the requirement of correction of most TOF.