Comparison of Minithoracotomy and Video-Assisted Thoracoscopic Surgery for Closure of Patent Ductuc Arteriosus

Surgical closure of patent ductus arterious(PDA) by lateral thoracotomy is considered as a standard therapy. But large incision, muscle cutting and chest pain are problematic. So I used two less invasive techniques : minithoracotomy and video-assisted thoracoscopic surgery. I tried to compare the results of them.

I reviewed the clinical records and operative reports of 22 children patients who were treated surgically between Jan. 19996 and Dec. 1996. Ten patients underwent Minithoracotomy(MT) and twelve patients Video-assisted thoracoscopic surgery(VATS). All of them were used tithanium clipping for closure of PDA.

Both groups were similar in age, body weight, Echocardiographically estimated size of PDA and Qp/Qs. All procedures were performed uneventfully. Operative time averaged 104±26 minutes for MT versus 96±31 minutes for VATS. Mean hospital stay was 7.2±1.7 days for MT and 4.6±1.2 days for VATS(p<0.05}. Postoperative hoarseness was occured in one patient(MT group) but was transient. There was no case with residual shunt confirmed by echocardiography.

Minithoracotomy and Video-assisted thoracoscopic surgery were as effective as lateral thoracotomy for closure of patent ductus arteriosus. Operative times were similar in two techniques but hospital stays were shorter in VATS group. Both MT and VATS techniques are effective and less invasive but I advocate VATS technique is more beneficial in terms of hospital stay and cosmetic aspect.