Thoracoscopic Surgery versus Median Sternotomy Surgery for Left Atrium Myxoma Excision: A Case Control Study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LIUJian ,  GUOHui-ming , XIEBin , CHENBo , HUANGHuan-lei , ZHANGXiao-shen , LIUJing , LUCong , CHENJi-mei , ZHUANGJian

Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangdong Provincial key Laboratory of South China Structural Heart Disease, Guangzhou 510080, P. R. China;

Corresponding author：

GUOHui-ming, Email: guohuiming@vip.tom.com

Keywords：

Thoracoscopy; Left atrium myxoma excision; Minimally invasive surgery

DOI：

10.7507/1007-4848.20160161

Video：

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Objective To examine the effect and safety of thoracoscopic surgery for left atrium myxoma excision. Method Sixty-nine left atrial myxoma patients underwent excision of left atrial myxoma in our hospital between January 2012 and August 2014 year. The patients were divided into two groups according to the procedure. Thirty patients under-went thoracoscopic surgery, as a thoracoscopic group, with 8 males and 22 females, aged 47.36±13.02 years. Thirty-nine patients received median sternotomy surgery, as a median sternotomy group, with 10 males and 29 females, aged 49.17±13.09 years. The effect and safety between the two groups were compared. Results All patients survived after surgery without death and other serious complications. Compared with the median sternotomy surgery group, longer cardiopul- monary bypass and aortic cross clamp time, shorter ICU stay, ventilator support, and postoperative drainage time, shorter hospital stay time, less postoperative drainage, lower cost, and more higher rate of returning to work in 1 month after surgery were found in the thoracoscopic group with P value less than 0.05. There was no complication of stroke and other neurological complication in the two groups. All patients were followed up for 11 months to 4 years and 7 months, average age of 38.5±12.7 months. There was no recurrence in both groups. Conclusions The thoracoscopic left atrial myxoma excision cardiopulmonary is effective and safe. It can be used as a surgical treatment of left atrial myxoma preferred.

Citation： LIUJian, GUOHui-ming, XIEBin, CHENBo, HUANGHuan-lei, ZHANGXiao-shen, LIUJing, LUCong, CHENJi-mei, ZHUANGJian. Thoracoscopic Surgery versus Median Sternotomy Surgery for Left Atrium Myxoma Excision: A Case Control Study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(7): 671-674. doi: 10.7507/1007-4848.20160161 Copy

1.	Mariscalco G, Musumeci F. The minithoracotomy approach:a safe and effective alternative for heart valve surgery. Ann Thorac Surg, 2014, 97(1) :356-64.
2.	刘健, 郭惠明, 谢斌, 等. 胸腔镜下二尖瓣生物瓣置换术32例分析. 中国胸心血管外科临床杂志, 2014, 21(5) :582-586.
3.	Reser D, van Hemelrijck M, Pavicevic J, et al. Repair rate and durability of video assisted minimally invasive mitral valve surgery. J Card Surg, 2014, 29(6) :766-771.
4.	Vollroth M, Seeburger J, Garbade J, et al. Minimally invasive mitral valve surgery is a very safe procedure with very low rates of conversion to full sternotomy. Eur J Cardiothorac Surg, 2012, 42(1) :e13-e16.
5.	金海, 徐志云, 于伟勇, 等. 微创小切口心脏瓣膜手术134例. 中国胸心血管外科临床杂志, 2005, 12(4) :237-239.
6.	Granov N, Kacila M, Solinas M, et al. Minimally invasive mitral valve surgery through right lateral minithoracotomy——early experience of Clinical Centre of University of Sarajevo. Med Arch, 2012, 66(5) :357-358.
7.	Chitwood WR Jr, Wixon CL, Elbeery JR, et al. Minimally invasive cardiac operation:adapting cardioprotective strategies. Ann Thorac Surg, 1999, 68(5) :1974-1977.
8.	王咏, 肖颖彬, 陈林, 等. 心脏肿瘤181例外科治疗的临床分析. 中国胸心血管外科临床杂志, 2013, 20(2) :155-158.
9.	Ito S, Endo A, Okada T, et al. Acute myocardial infarction due to left atrial myxoma. Intern Med, 2016, 55(1) :49-54.
10.	Schaff HV, Mullany CJ. Surgery for cardiac myxomas. Semin Thorac Cardiovasc Surg, 2000, 12(2) :77-88.
11.	Deshpande RP, Casselman F, Bakir I, et al. Endoscopic cardiac tumor resection. Ann Thorac Surg, 2007, 83(6) :2142-2146.
12.	Owais TA, Farber G, Garbade J, et al. Excision of a left atrial myxoma via a minimally-invasive technique:a possible routine access. Interact Cardiovasc Thorac Surg, 2011, 12(5) :875-877.
13.	Vistarini N, Alloni A, Aiello M, et al. Minimally invasive video-assisted approach for left atrial myxoma resection. Interact Cardiovasc Thorac Surg, 2010, 10(1) :9-11.
14.	Disesa VJ, Collins JJ Jr, Cohn LH. Considerations in the surgical management of left atrial myxoma. J Card Surg, 1988, 3(1) :15-22.
15.	Panos A, Kalangos A, Sztajzel J. Left atrial myxoma presenting with myocardial infarction. Case report and review of the literature. Int J Cardiol, 1997, 62(1) :73-75.
16.	Yu S, Xu X, Zhao B, et al. Totally thoracoscopic surgical resection of cardiac myxoma in 12 patients. Ann Thorac Surg, 2010, 90(2) :674-676.
17.	Modi P, Hassan A, Chitwood WR Jr. Minimally invasive mitral valve surgery:a systematic review and meta-analysis. Eur J Cardiothorac Surg, 2008, 34(5) :943-952.
18.	Schroder C, Leukhardt WH, Hsiao EM, et al. Transaortic video-assisted resection of a recurrent left ventricular myxoma. Ann Thorac Surg, 2013, 95(1) :340-342.
19.	Ko PJ, Chang CH, Lin PJ, et al. Video-assisted minimal access in excision of left atrial myxoma. Ann Thorac Surg, 1998, 66(4) :1301-1305.
20.	Panos A, Myers PO. Video-assisted cardiac myxoma resection:basket technique for complete and safe removal from the heart. Ann Thorac Surg, 2012, 93(4) :e109-e110.

1. Mariscalco G, Musumeci F. The minithoracotomy approach:a safe and effective alternative for heart valve surgery. Ann Thorac Surg, 2014, 97(1) :356-64.
2. 刘健, 郭惠明, 谢斌, 等. 胸腔镜下二尖瓣生物瓣置换术32例分析. 中国胸心血管外科临床杂志, 2014, 21(5) :582-586.
3. Reser D, van Hemelrijck M, Pavicevic J, et al. Repair rate and durability of video assisted minimally invasive mitral valve surgery. J Card Surg, 2014, 29(6) :766-771.
4. Vollroth M, Seeburger J, Garbade J, et al. Minimally invasive mitral valve surgery is a very safe procedure with very low rates of conversion to full sternotomy. Eur J Cardiothorac Surg, 2012, 42(1) :e13-e16.
5. 金海, 徐志云, 于伟勇, 等. 微创小切口心脏瓣膜手术134例. 中国胸心血管外科临床杂志, 2005, 12(4) :237-239.
6. Granov N, Kacila M, Solinas M, et al. Minimally invasive mitral valve surgery through right lateral minithoracotomy——early experience of Clinical Centre of University of Sarajevo. Med Arch, 2012, 66(5) :357-358.
7. Chitwood WR Jr, Wixon CL, Elbeery JR, et al. Minimally invasive cardiac operation:adapting cardioprotective strategies. Ann Thorac Surg, 1999, 68(5) :1974-1977.
8. 王咏, 肖颖彬, 陈林, 等. 心脏肿瘤181例外科治疗的临床分析. 中国胸心血管外科临床杂志, 2013, 20(2) :155-158.
9. Ito S, Endo A, Okada T, et al. Acute myocardial infarction due to left atrial myxoma. Intern Med, 2016, 55(1) :49-54.
10. Schaff HV, Mullany CJ. Surgery for cardiac myxomas. Semin Thorac Cardiovasc Surg, 2000, 12(2) :77-88.
11. Deshpande RP, Casselman F, Bakir I, et al. Endoscopic cardiac tumor resection. Ann Thorac Surg, 2007, 83(6) :2142-2146.
12. Owais TA, Farber G, Garbade J, et al. Excision of a left atrial myxoma via a minimally-invasive technique:a possible routine access. Interact Cardiovasc Thorac Surg, 2011, 12(5) :875-877.
13. Vistarini N, Alloni A, Aiello M, et al. Minimally invasive video-assisted approach for left atrial myxoma resection. Interact Cardiovasc Thorac Surg, 2010, 10(1) :9-11.
14. Disesa VJ, Collins JJ Jr, Cohn LH. Considerations in the surgical management of left atrial myxoma. J Card Surg, 1988, 3(1) :15-22.
15. Panos A, Kalangos A, Sztajzel J. Left atrial myxoma presenting with myocardial infarction. Case report and review of the literature. Int J Cardiol, 1997, 62(1) :73-75.
16. Yu S, Xu X, Zhao B, et al. Totally thoracoscopic surgical resection of cardiac myxoma in 12 patients. Ann Thorac Surg, 2010, 90(2) :674-676.
17. Modi P, Hassan A, Chitwood WR Jr. Minimally invasive mitral valve surgery:a systematic review and meta-analysis. Eur J Cardiothorac Surg, 2008, 34(5) :943-952.
18. Schroder C, Leukhardt WH, Hsiao EM, et al. Transaortic video-assisted resection of a recurrent left ventricular myxoma. Ann Thorac Surg, 2013, 95(1) :340-342.
19. Ko PJ, Chang CH, Lin PJ, et al. Video-assisted minimal access in excision of left atrial myxoma. Ann Thorac Surg, 1998, 66(4) :1301-1305.
20. Panos A, Myers PO. Video-assisted cardiac myxoma resection:basket technique for complete and safe removal from the heart. Ann Thorac Surg, 2012, 93(4) :e109-e110.

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Thoracoscopic Surgery versus Median Sternotomy Surgery for Left Atrium Myxoma Excision: A Case Control Study

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