Small incision closure through the chest trumps traditional thoracotomy for VSD

Small incision closure through the chest has significant clinical curative effects for children with ventricular septal defect (VSD), a recent study has found. Moreover, the minimally invasive procedure shortens operation time and reduces intraoperative blood loss and inflammation.

The study included 70 children with VSD who were randomly assigned to undergo traditional thoracotomy (n=35) or small incision closure through the chest (n=35). Outcomes included clinical curative effect, operation indices, postoperative complications, and changes in cardiac function measures and inflammatory biomarkers, as compared between the two arms.

The total response rate in the small incision group was 100 percent, significantly higher than the 85.71-percent response rate in the thoracotomy arm (p<0.05). In particular, five patients did not respond to thoracotomy. The intervention led to a conspicuous effect in 74.28 percent and 62.86 percent of patients undergoing small incision closure and traditional thoracotomy, respectively.

Small incision closure likewise proved to be a safer procedure to perform, leading to significantly lower intraoperative blood loss (152.09±27.41 vs 258.13±36.36 mL) and shorter operation time (1.21±0.23 vs 2.83±0.41 h; p<0.05), postoperative mechanical ventilation time (5.37±1.02 vs 14.17±3.56 h; p<0.05), and length of stay (8.39±2.49 vs 12.73±3.78 h; p<0.05).

The overall incidence of postoperative complications was likewise significantly lower in the small incision closure group (5.71 percent vs 25.71 percent; p<0.05).

“Small incision closure through the chest of VSD in children has a significant clinical curative effect. It can effectively shorten the operation time, reduce intraoperative blood loss, improve ventricular function, and reduce inflammatory reaction, and therefore it has high safety and is worthy of further popularization in clinical practice,” the researchers said.