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CLC number: R654.2

On-line Access: 2014-06-07

Received: 2013-08-10

Revision Accepted: 2014-02-10

Crosschecked: 2014-05-26

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Journal of Zhejiang University SCIENCE B 2014 Vol.15 No.6 P.522-532

http://doi.org/10.1631/jzus.B1300210


Anterolateral minithoracotomy versus median sternotomy for mitral valve disease: a meta-analysis


Author(s):  Chao Ding1, Da-ming Jiang2, Kai-yu Tao2, Qun-jun Duan2, Jie Li3, Min-jian Kong2, Zhong-hua Shen2, Ai-qiang Dong2

Affiliation(s):  1. Department of Gynaecology, Zhejiang Cancer Hospital, Hangzhou 310022, China; more

Corresponding email(s):   to_jiangdm@163.com

Key Words:  Minimally invasive surgical procedures, Anterolateral minithoracotomy (ALMT), Median sternotomy (MS), Mitral valve, Meta-analysis


Chao Ding, Da-ming Jiang, Kai-yu Tao, Qun-jun Duan, Jie Li, Min-jian Kong, Zhong-hua Shen, Ai-qiang Dong. Anterolateral minithoracotomy versus median sternotomy for mitral valve disease: a meta-analysis[J]. Journal of Zhejiang University Science B, 2014, 15(6): 522-532.

@article{title="Anterolateral minithoracotomy versus median sternotomy for mitral valve disease: a meta-analysis",
author="Chao Ding, Da-ming Jiang, Kai-yu Tao, Qun-jun Duan, Jie Li, Min-jian Kong, Zhong-hua Shen, Ai-qiang Dong",
journal="Journal of Zhejiang University Science B",
volume="15",
number="6",
pages="522-532",
year="2014",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.B1300210"
}

%0 Journal Article
%T Anterolateral minithoracotomy versus median sternotomy for mitral valve disease: a meta-analysis
%A Chao Ding
%A Da-ming Jiang
%A Kai-yu Tao
%A Qun-jun Duan
%A Jie Li
%A Min-jian Kong
%A Zhong-hua Shen
%A Ai-qiang Dong
%J Journal of Zhejiang University SCIENCE B
%V 15
%N 6
%P 522-532
%@ 1673-1581
%D 2014
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B1300210

TY - JOUR
T1 - Anterolateral minithoracotomy versus median sternotomy for mitral valve disease: a meta-analysis
A1 - Chao Ding
A1 - Da-ming Jiang
A1 - Kai-yu Tao
A1 - Qun-jun Duan
A1 - Jie Li
A1 - Min-jian Kong
A1 - Zhong-hua Shen
A1 - Ai-qiang Dong
J0 - Journal of Zhejiang University Science B
VL - 15
IS - 6
SP - 522
EP - 532
%@ 1673-1581
Y1 - 2014
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B1300210


Abstract: 
Objective: mitral valve disease tends to be treated with anterolateral minithoracotomy (ALMT) rather than median sternotomy (MS), as ALMT uses progressively smaller incisions to promote better cosmetic outcomes. This meta-analysis quantifies the effects of ALMT on surgical parameters and post-operative outcomes compared with MS. Methods: One randomized controlled study and four case-control studies, published in English from January 1996 to January 2013, were identified and evaluated. Results: ALMT showed a significantly longer cardiopulmonary bypass time (P=0.001) and aortic cross-clamp time (P=0.05) compared with MS. However, the benefits of ALMT were evident as demonstrated by a shorter length of hospital stay (P<0.00001). According to operative complications, the onset of new arrhythmias following ALMT decreased significantly as compared with MS (P=0.05); however, the incidence of peri-operative mortality (P=0.62), re-operation for bleeding (P=0.37), neurologic events (P=0.77), myocardial infarction (P=0.84), gastrointestinal complications (P=0.89), and renal insufficiency (P=0.67) were similar to these of MS. Long-term follow-up data were also examined, and revealed equivalent survival and freedom from mitral valve events. Conclusions: Current clinical data suggest that ALMT is a safe and effective alternative to the conventional approach and is associated with better short-term outcomes and a trend towards longer survival.

二尖瓣瓣膜病行右前外侧小切口与胸骨正中切口手术研究的meta分析

研究目的:二尖瓣瓣膜病越来越趋向于应用右前外侧小切口(ALMT)替代胸骨正中切口(MS)进行手术,因为其更美观、微创。本文主要是比较分析ALMT组与MS组的手术参数及术后结果。
研究方法:从1996年1月至2013年1月期间发表的英文论文中,选出1篇随机对照研究及4篇病例对照研究进行分析。
重要结论:目前的临床数据显示,相比较于传统的胸骨正中切口二尖瓣手术,右前外侧小切口手术是一种安全、有效的方法,具有较好的近期和远期疗效。

关键词:微创手术;胸部小切口;正中开胸;二尖瓣;Meta分析

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article

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