CHSJ

Curr Health Sci J, vol. 52, no. 3, 2026

Video-Assisted Thoracoscopic Surgery versus Open Sternotomy for Cardiac Procedures: A Cohort Study of Comparative Outcomes

[Original Paper]

W. ALI(1), A. RAZA(1), R. FAISAL(2), M.A.A. MALIK(3), A. MANSOOR(4), O. MUDASSIR(5), M.N.M.A. MALIK(6), A.R. AKRAM(7), S.M. HAIDER(8), A. AHMADZAI(9), A. SAEED(10)


(1)Department of Medicine, Dow International Medical College, Karachi, Sindh, Pakistan;
(2)Department of Surgery, National University of Medical Sciences
(NUMS), Rawalpindi, Pakistan;
(3)Department of Medicine, Saudi Rapid Plus Medical Services, Riyadh, Saudi Arabia;
(4)Department of Medicine, Faisalabad Medical University, Faisalabad, Pakistan;
(5)Department of Cardiac Surgery, Pakistan Institute of Medical Sciences
(PIMS), Islamabad, Pakistan;
(6)Department of Medicine, Foundation University Medical College, Foundation University Islamabad, Pakistan;
(7)Department of Medicine, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India;
(8)Department of Thoracic Surgery, King Edward Medical University, Lahore, Punjab, Pakistan;
(9)Department of Medicine, Niagara University, Lewiston, New York, United States;
(10)Department of Medicine, Naizi Medical & Dental College, Sargodha, Punjab, Pakistan


Abstract:

Background: Median sternotomy is the conventional method of cardiac surgery, yet has postsurgical complications and long recuperation periods. Video-assisted thoracoscopic surgery (VATS) is a new minimally invasive option that may give patients a better recovery without compromising safety. Methods: A retrospective cohort study was conducted using medical records from tertiary cardiac surgery hospitals. A total of 400 adult patients were included, comprising 187 patients who underwent VATS and 213 who underwent open sternotomy. Demographic and clinical characteristics, ICU stay, hospital stay, ventilation time, postoperative complications, and mortality were assessed. Comparisons were made using Mann-Whitney U and chi-square tests, and multivariable regression analyses were performed to account for confounding factors. Results: Patients in the VATS group had significantly shorter ICU stays (2.0 vs. 3.0 days, p<0.001), hospital stays (6.0 vs. 8.0 days, p<0.001), and ventilation times (16.0 vs. 30.0 hours, p<0.001). Postoperative infection (8% vs. 15%, p=0.028) and bleeding (5% vs. 11%, p=0.041) were less frequent following VATS. There was no significant difference in mortality rates between the groups (2% vs. 3%, p=0.512). The relationship between VATS and better recovery and fewer complications was confirmed by the adjusted analyses. Conclusions: VATS was associated with better postoperative recovery and fewer complications than open sternotomy, despite similar short-term mortality rates. VATS proves to be a safe and effective minimally invasive option for particular cardiac surgery patients, according to these results.


Keywords: Video-assisted thoracoscopic surgery, open sternotomy, cardiac surgery, minimally invasive surgery, postoperative outcomes.



Corresponding: Ahmed Saeed, Department of Medicine, Naizi Medical & Dental College, Sargodha, Punjab, Pakistan, e-mail: ahmedsaeedd4270@gmail.com


DOI 10.12865/CHSJ.52.03.04 - Download PDF
current issue cover Download cover
Download contents

Journal archive