비디오 흉강경을 이용한 동맥관 개존증 수술

Background and Objectives：Video-Assisted Thoracoscopic surgery for Patent Ductus Arteriosus is an efficient method to reduce the risk of postoperative residual shunt as well as various complications that can be caused by a thoracotomy. The aim of this study was to analyze the safety and efficacy of ductus arteriosus clipping, using videothoracoscopy in sixty-five patients, and the results and prognosis of the operations. Subjects and Methods：After general anesthesia of the sixty-five Patent Ductus Arteriosus (PDA) patients, double skin incisions of 7 and 5 mm were made and a thoracoscope inserted at the point of the 5 mm skin incision, with clipping of ductus arteriosus using the 7 mm skin incision were conducted. During the procedure, the tidal volume was kept at the minimum level to maintain O2 saturation, without insertion of a chest tube. Results：There have been reported complications in fourteenth cases, with four of these caused by injury to the recurrent laryngeal nerve；however, they recovered after two weeks, with the other ten receiving a remnant residual shunt. Nine of ten residual shunt cases cured naturally after about six months, with no special treatments. Conclusion：Surgery using Video-Assisted thoracoscopic surgery for the PDA patients can decrease the complications due to a thoracotomy, and is therefore, a much safer and more effective method than other existing solutions.