Hasan İNER, Nihan YEŞİLKAYA, İhsan PEKER, Ali GÜRBÜZ, Yüksel BEŞİR, Ertürk KARAAĞAÇ, Börteçin EYGİ, Levent YILIK, Orhan GÖKALP

Atriyal septal defekt kapatılmasında mini-torakotomi ve medyan sternotominin karşılaştırılması: Mini-torakotomi standart teknik olmalı mı?

Amaç: Bu çalışmada atriyal septal defekt kapatılmasında mini-torakotomi ve medyan sternotominin sonuçları karşılaştırıldı. Çalışma planı: Ocak 2012 - Mayıs 2017 yılları arasında kliniğimizde mini-torakotomi veya medyan sternotomi ile atriyal septal defekt tamiri yapılan toplam 44 hasta (8 erkek, 36 kadın; ort. yaş 33.86 yıl; dağılım, 14-63 yıl) retrospektif olarak incelendi. Hastaların ameliyat öncesi, sırası ve sonrasına ilişkin veriler kaydedildi. Bulgular: Ameliyat süresi mini-torakotomi grubunda daha kısa olmakla birlikte, kardiyopulmoner baypas ve kros klemp süreleri açısından gruplar arasında anlamlı bir fark yoktu (p=0.001). Gruplar arasında erken mortalite, nörolojik komplikasyonlar ve rezidüel atriyal septal defekt açısından anlamlı bir fark izlenmedi. Mini-torakotomi grubunda ortalama mekanik ventilasyon süresi ve yoğun bakım ünitesi ve hastanede kalış süresi istatistiksel olarak anlamlı düzeyde daha kısa ve kanama miktarı istatistiksel olarak anlamlı düzeyde daha azdı (tümü için p=0.001). Sonuç: Mini-torakotomi daha az maliyet ve daha fazla hasta yararı ile tatmin edici bir öğrenme eğrisi döneminden sonra sternotomiye uygun bir alternatif olarak akılda tutulmalıdır.

Mini-thoracotomy versus median sternotomy for atrial septal defect closure: Should mini-thoracotomy be applied as a standard technique?

Background: This study aims to compare outcomes of minithoracotomyversus median sternotomy for atrial septal defectclosure.Methods: Between January 2012 and May 2017, a total of44 patients (8 males, 36 females; mean age 33.86 years;range, 14 to 63 years) who underwent atrial septal defect repairthrough mini-thoracotomy or median sternotomy in our clinicwere retrospectively analyzed. Pre-, intra-, and postoperativedata of the patients were recorded.Results: There was no significant difference in thecardiopulmonary bypass and cross-clamp times between thegroups, although the duration of operation was shorter in themini-thoracotomy group (p=0.001). No significant differencewas observed between the groups in terms of early mortality,neurological complications, and residual atrial septal defect. Themean mechanical ventilation time and length of intensive careunit and hospital stay were statistically significantly shorter, andthe amount of bleeding was statistically significantly lower in themini-thoracotomy group (p=0.001 for all).Conclusion: Mini-thoracotomy should be kept in mind as afavorable alternative to sternotomy following a satisfactorylearning curve period with less cost and higher patient benefit.

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