Extended vertical transseptal approach versus transseptal approach for mitral valve operation.

BACKGROUND: Adequate exposure of the mitral valve is a critical factor of success for either replacement or repair of the mitral valve. In the present study, we evaluated the merits of the extended vertical transseptal approach in comparison with the transseptal approach for mitral valve operations. METHODS: A total of 72 consecutive patients operated on for mitral procedures were allocated to either group A (those operated on through an extended vertical transseptal approach [n = 38]) or group B (whose mitral valve exposure was achieved through a right atrium transseptal approach [n = 34]). The operation time, aortic cross-clamp time, first 24-hour drainage volume after the operation, and the rhythms pre- and postsurgery were compared between the 2 groups. RESULTS: The mean operation time and mean cross-clamp time in group A were longer than that in group B and the drainage volume was greater in the first 24 hours, but the differences were not statistically significant. There was no surgical reexploration for bleeding in either group. For the 13 patients who had normal sinus rhythm preoperatively in group A, 2 (15.4%) developed episodes of atrial fibrillation and 1 (7.7%) developed temporary sinus bradycardia requiring temporary pacing in the immediate and early postoperative period. In group B, 2(15.4%) of patients with normal sinus rhythm before surgery developed atrial fibrillation that continued until 1 week after surgery. CONCLUSION: The extended vertical transseptal approach not only affords excellent exposure of the mitral valve, but also is safe for maintaining sinus node function compared with the transseptal approach.

Application of Da Vinci Robot and Thoracoscopy in Radical Lung Cancer Surgery.

In this article, we have explored the feasibility and safety of Da Vinci's robotic surgery system in the radical resection of lung cancer. For this purpose, 73 cases of patients with lung cancer who underwent radical resection in the thoracic surgery of our hospital, particularly from July to September 2020, were collected, of which 22 cases operated with the Da Vinci robot were the Da Vinci robot group, including 11 men and 11 women. The 51 patients who underwent thoracoscopic surgery were in the thoracoscopic group, including 24 males and 27 females. All 22 patients in the Da Vinci robot group completed the operation under the Da Vinci robot operation system without conversion to thoracotomy. In the thoracoscopic group, 49 patients successfully completed the operation under thoracoscopy, and 2 patients were converted to thoracotomy. There was a significant difference between the two groups in the average operation time and the number of lymph nodes, but there was no significant difference in the amount of intraoperative bleeding and postoperative hospital stay. Compared with thoracoscopic radical lung cancer surgery, Da Vinci's robotic surgery system is equally safe and effective, and more lymph nodes are cleaned during surgery.