Abstract
Background Minimally invasive surgery has become the standard approach for several cardiac diseases.
In this retrospective study, we compared right anterolateral minithoracotomy (RALT)
with standard median sternotomy (SMS) for resection of left atrial myxoma (LAM).
Materials and Methods From January 2009 to June 2015, the clinical data of patients who underwent RALT
(n = 30) and SMS (n = 36) for resection of LAM in our hospital were collected. The preoperative clinical
data and operative results were compared between the two groups.
Results There were no significant differences in aortic cross-clamp and cardiopulmonary bypass
time between the two groups. The total incision length was significantly shorter in
RALT group compared with SMS group (p < 0.001). For RALT and SMS groups, respectively, the intensive care unit length of
stay was 29.2 ± 6.5 versus 43.5 ± 6.9 hours (p < 0.001), and the postoperative hospital length of stay was 5 days (interquartile
range [IQR]: 4–6) versus 8 days (IQR: 7–10) (p < 0.001). The total cost in RALT group was 27,000 RMB (IQR: 25,000–29,000) versus
33,000 RMB (IQR: 31,000–35,000) in SMS group (p < 0.001). There were no significant differences in mortality and postoperative complications
between the two groups.
Conclusion RALT approach for LAM resection can be performed safely with favorable cosmetic outcome,
accepted clinical results, and lower cost. It should be considered as a promising
alternative to SMS and merit additional study.
Keywords
minimally invasive surgery - myxoma - incisions
