关键词: 电视辅助胸腔镜手术, 结核性缩窄性心包炎, 心包剥脱术, 微创外科手术

Abstract: Tuberculous constrictive pericarditis is characterized by chronic pericardial inflammation, thickening, adhesion and calcification caused by Mycobacterium tuberculosis infection. Pericardial constriction compresses the myocardium and great vessels, leading to a series of clinical manifestations of circulatory disturbance. Surgical pericardiectomy is the core treatment for this disease. Conventional surgical approaches are mainly median sternotomy and left anterolateral thoracotomy. This paper reports 5 patients with tuberculous constrictive pericarditis who underwent video-assisted thoracoscopic surgery (VATS) at the Fourth Hospital of Chaoyang from August 2018 to July 2022. All patients underwent partial pericardiectomy via the left thoracic approach using the three-port or single-operating-port technique. Among them, 1 patient complicated with left chronic tuberculous empyema received simultaneous decortication of the fibrous pleura. All 5 operations were successfully completed without conversion to open thoracotomy. Standardized anti-tuberculosis medication was administered during the perioperative period. Postoperative follow-up ranged from 13 to 36 months. All patients were cured, with favorable recovery of cardiac function and no recurrence observed.

Key words: Video-assisted thoracoscopic surgery, Tuberculous constrictive pericarditis, Pericardiectomy, Minimally invasive surgical procedure