完全胸腔镜下二尖瓣手术272例

The 272 cases clinical results of totally thoracoscopic cardiac surgery for mitral valve diseases

目的总结胸壁3孔完全胸腔镜下二尖瓣手术的临床效果。方法2004年5月至2011年10月272例行完全胸腔镜下二尖瓣手术，统计分析其病例选择、术中资料和术后随访资料。结果全组手术2．1～3．9h，平均（3．0±1．2）h；体外循环76～158min，平均（98±22）min；升主动脉阻断38～78min，平均（52±13）min。术后呼吸机辅助5．8～34．5h，平均（11．2±3．6）h；住监护室14—67h，平均（28．2±7．6）h；术后胸液引流量20～1200ml，平均（370±80）ml。术后死亡1例。余者术后住院7～18天，平均（10．2±2．1）天。术后并发症14例。结论胸壁3孔完全胸腔镜下二尖瓣手术创伤小、出血少、住院时间短、美观。

Objective To summarize the clinical results of totally thoracoscopic cardiac surgery for mitral valve diseases. Methods From May 2004 to October 2011,272 patients underwent totally thoracoscopic cardiac surgery for mitral valve diseases through three ports. Summarize the indication and contraindication are used and for the operation date. Results There was 1 case in-hospital deaths. The time of operations was 2.10- 3.9 （ 3.0 ± 1.2 ） h. Time of cardiopulmonary bypass and aortic cross-clamp was 76 - 158 （98 ± 22 ） minites and 38 - 78 （52 ± 13 ） minites. Time of mechanical ventilation and intensive care unit stay was 5.8 - 34.5 （ 11.2 ± 3.6 ） hours and 14 - 67 （ 28.2 ± 7.6 ） hours. The volume of drainage was 20 - 1200 （ 370 ± 80 ） ml. The hospital days were 7 - 18 （ 10.2 ± 2.1 ） days. The postoperative complications occurred in 14 cases. Conclusion Totally thoracoscopic cardiac surgery for mitral valve diseases is technically feasible and safe with less drainage and shortened hospital stay.