ABSTRACT
@#Objective To analyze the clinical efficacy of transthoracic occlusion via a right subaxillary incision and conventional surgery in the treatment of ventricular septal defect (VSD). Methods The clinical data of patients with congenital VSD undergoing right subaxillary incision surgery in our hospital from January 2017 to January 2020 were retrospectively analyzed. According to the surgical methods, the patients were divided into two groups: a conventional surgery group (conventional group) and a transthoracic occlusion group (occlusion group). There were 221 patients in the conventional group, including 97 males and 124 females, with an average age of 2.6±2.2 years and an average weight of 13.4±6.2 kg; there were 185 patients in the occlusion group, including 90 males and 95 females, with an average age of 3.2±2.6 years and an average weight of 14.7±6.6 kg. The clinical effectiveness was compared. Results The success rate of surgery was 100% in both groups. The intraoperative blood loss was less in the occlusion group (P<0.05). The incision length, operation time, postoperative mechanical ventilation time, retention time in the intensive care unit, the time to resume normal diet and normal activities after operation were all shorter than those in the conventional group (P all <0.05). The total cost during hospitalization of the conventional group was less than that of the occlusion group (P<0.001). There was no statistical difference in the incidence rate of perioperative complications between the two groups (P>0.05). During the follow-up (15.8±8.8 months), the incidence of complications in the conventional group was higher than that in the occlusion group with a statistical difference (P<0.001). Conclusion Compared with conventional surgery, transthoracic occlusion for VSD via right subaxillary incision has the advantages of smaller incision, shorter operation time, less blood loss, shorter postoperative recovery time and less long-term complications. However, the total hospitalization cost is relatively high, mainly because of the high consumables cost, and the long-term effects still need further comparative observation.
ABSTRACT
Objective To evaluate efficacy and safety of transcatheter patent ductus arteriosus(PDA) closure compared with mini-incision transthoracic occlusion in children.Methods The safety and complications of 175 patients who underwent transcatheter closure(transcatheter group) hospitalized in Department of Pediatrics,Linyi People's Hospital were analyzed,the ages ranging from 3 months to 14 years,and the material used was Chinese homemade occluder except for the spring coil.Compared with the 157 patients who underwent mini-incision transthoracic occlusion (mini-incision group) hospitalized in Department of Heart Surgery,Linyi People's Hospital from Jan.2009 to Nov.2013,the ages ranging from 5 months to 14 years,the material used was same as the transcatheter group.Acquired data was processed through statistics.Results One hundred and seventy-one of the 175 patients achieved success in the transcatheter group,technically success rate was 97.71％,there were 8 patients with complications,but no death,the occurrence rate of complications was 4.57％ ;however,137 of 157 patients achieved success in the mini-incision group,technically success rate was 87.26％,there were 21 patients with complications and 1 death,the occurrence rate of complications was 13.38％.Success rate of the transcatheter group was much higher than the mini-incision group(x2 =8.05,P ＜ 0.01),while complications of the transcatheter group was significantly less than the mini-incision group(x2 =13.48,P ＜ 0.01),and also the transcatheter group had less hemorrhage during operation,shorter operation time,shorter hospital stay and less hospital expenses compared with the mini-incision group [(0.021 ± 0.007) L vs (0.088 ± 0.027) L,(36.81± 7.19) minvs (88.65 ±27.92) min,(4.16±0.45) dvs (10.68 ±2.38) d,(27 943.6± 2754.1) RMBvs(35037.4±8659.2) RMB;t=29.23,22.19,33.44,18.47,allP＜0.01].Conclusions Transcatheter PDA closure in children is better than mini-incision transthoracic occlusion because of its higher efficacy and lower risk,so it is the first choice of treatment to the children with PDA.