微创医学

目的探讨微创右胸侧切口行小儿先天性心脏病的适应范围及相对传统正中开胸手术的优势。方法针对小儿先天性心脏病所实施的微创右胸侧切口手术共32例。32例患者均采用右胸侧切口，长约8～12 cm，经第3或4肋间进胸，行房间隔缺损修补术21例，室间隔缺损修补术11例。结果32例患者全部经右胸侧切口顺利完成心内直视手术，全部康复出院，无1例出现术后残余漏。结论微创右胸侧切口适用于诊断明确的先天性心脏病，相对传统正中开胸手术，其手术切口隐蔽且较小，不破坏胸骨连续性，出血量减少，术后疼痛减轻、康复快。

ObjectiveTo investigate the indication of right chest small margin surgical treatment for congenital heart disease in children and its relative advantages to the traditional middle thoracotomy. MethodsThirtytwo cases of children congenital heart disease underwent right chest small margin surgical treatment .The incision was located at right axillary midline, with a diameter of about 8-12 cm ,and through the third or the fourth intercostal space. Twenty one patients underwent the atrial septal defect repair, and the other 11 underwent the ventricular septal defect repair. ResultsAll the patients successfully underwent the righ t axillary incision for open heart surgery, and were discharged smoothly, without any postoperative residual leakage. ConclusionRight chest small margin surgical treatment for congenital heart disease is suitable for congenital heart disease with definite diagnosis. Compared to the traditional median thoracotomy incision, the right chest incision is more hidden and smaller, and it remains the continuity of the sternum, with less bleeding, less postoperative pain, but faster rehabilitation

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