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右前侧小胸切除术和小胸切除术用于大动脉置换的比较结果:更新的元分析

Kristine Santos^1,2, Clara Campoverde Fárez³, Victoria Zecchin Ferrara⁴

¹Department of Cardiothoracic Surgery, Medisch Spectrum Twente, Enschede, Netherlands.

Innovations (Philadelphia, Pa.)

|December 2, 2025

概括

右前部小胸口切除术 (RAMT) 提供了较短的住院时间和较少的血液损失,用于最少侵入性大动脉置换 (MIAVR). 然而,与 ministernotomy 相比,它涉及更长的心肺绕道时间和增加的切口疼痛.

科学领域:

心血管外科心血管外科
胸部外科手术胸部外科手术
最少侵入性心脏外科手术

背景情况:

右前部小胸口切除术 (RAMT) 和小胸口切除术 (MS) 是标准的轻度侵入性大动脉置换 (MIAVR) 技术.
对于MIAVR的最佳技术选择仍在争论中,缺乏对比结果的共识.

研究的目的:

为了比较RAMT对MIAVR的有效性和安全性与MS.
确定哪种外科手术方法能产生优异的患者结果.

主要方法:

在MEDLINE,Scopus和Cochrane图书馆进行了系统的文献搜索.
用RevMan软件对21项涉及6986名患者的研究进行了元分析,比较RAMT和MS的MIAVR.

主要成果:

拉姆特与更短的住院时间,减少血液流失,更低的输血率和急性损伤 (AKI) 的减少有关.
相反,RAMT显示了更长的心肺绕道 (CPB) 时间和更高的切口疼痛得分.
死亡率,中风发病率和其他并发症在RAMT和MS之间是可比的.

结论:

RAMT提供了诸如更短的住院时间和减少血流,输血和AKI等并发症等好处.
这些优势被增加的CPB持续时间和切口疼痛所平衡,需要个性化的患者选择.
患者的风险,解剖学和康复目标应指导MIAVR的RAMT和MS之间的选择.

关键词:

大动脉门的大动脉门部长进行了切除术.这是一个微型的thoracotomy.

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