Impact of aortic dissection surgery through a single small incision in the upper sternum on the perioperative respiratory function of patients
LIU Zhi-shuo
XIA Lin
WANG Lu
SUN Biao
YANG Zhong-lu
GE Yu-guang
JIANG Hui
Abstract：Objective To explore the impact on perioperative respiratory function of patients when applying a single small incision in the upper sternum for aortic dissection surgery compared with the traditional median sternotomy.Methods A total of 113 patients with acute Stanford type A aortic dissection who underwent total aortic arch replacement combined with frozen elephant trunk implantation by the same surgical team at the Northern Theater General Hospital from August 2020 to February 2022 were selected as the study subjects.Patients were divided into a small incision group with 68 cases and a median sternotomy group with 45 cases.The general clinical data,perioperative conditions postoperative respiratory function-related indexes and pain scores of the 2 groups were statistically analyzed.Results Compared with patients with median sternotomy group patients in the small incision group had reduced intraoperative bleeding and blood transfusion,less 24-hour postoperative drainage,shorter indwelling drains,and lower incidence of sternal doodads(P＜0.05).The lower rates of reintubation and higher oxygenation index on the fifth day after surgery in patients in the small incision group(P＜0.05).Additionally,patients in the small incision group had lower pain scores on the first,third,and seventh days after surgery than patients in the median sternotomy group(P＜0.05).Conclusion The small incision in the upper sternum for total aortic arch replacement combined with frozen elephant trunk implantation shows safe and effective reduces bleeding,blood transfusion,drainage volume,incidence of poor incision healing,improves the postoperative oxygenation index and reduces pain as a means to protect and improve respiratory function.
Keywords：Smallincision in the uppersternumAortic dissectionTotalaorticarch replacementFrozen elephant trunk implantationRespiratory functionNumerical rating scale
Publication Date：2024-12-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 348-351,356 )