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目的：报告４２例６月龄至６．５岁法乐四联症病儿，经右外侧小切口行剖胸根治术病例。方法：取右侧腋后线与第３后肋交点为切口后上缘、腋前线与第６后肋交点为切口前下缘，在两点间作一长约６～８ｃｍ弧形切口，于胸肌深面潜行游离至第４或３肋间进胸。行单纯心包补片加宽右心室流出道２２例，跨瓣环补片２０例，其中１４例跨瓣环补片直至左右肺动脉分叉处，９例采用了液氮保存的成人同种带瓣大动脉单瓣跨环补片。结果：本组无死亡。与同期相匹配的一组１３１例正中剖胸法乐四联症根治术相比，心肌阻断［（６０．９０±１４．２０）分钟对（６２．３６±１５．７３）分钟］，术后呼吸机辅助时间［（２３．９４±１８．９３）小时对（２７．９８±１９．６７）小时］差异无显著性；而胸液引流量明显减少［（１５５．２２±６３．１７）ｍｌ对（１９２．９５±６１．５８）ｍｌ］，术后住院时间明显缩短［（７．１５±０．５８）天对（７．９３±３．６３）天］。结论：右外侧小切口剖胸根治小儿法乐四联症疗效好、安全、可靠。
OBJECTIVE: To report 42 cases of tetralogy of Fallot from 6 months to 6.5 years old who underwent radical thoracotomy by right lateral incision. Methods: The intersection of the right posterior axillary line and the third posterior rib was taken as the upper edge of the incision. The intersection of the anterior axillary line and the sixth posterior was the anterior inferior incision. A curved incision of about 6 ~ 8cm in length was made between the two points. Deep sneak free to the 4th or 3rd intercostal into the chest. Simple pericardial patch widening of the right ventricular outflow tract in 22 cases, 20 cases of transvalvular patch, 14 cases across the valve ring until the left and right pulmonary artery bifurcation, 9 cases of liquid nitrogen stored in the same kind of petals Aortic valve cross-ring patch. Results: There was no death in this group. Compared with the same group of 131 cases of midline thoracotomy with tetralogy of Fallot, myocardial infarction [(60.90 ± 14.20) min vs (62.36 ± 15.73) min] Post-ventilator assisted time [(23.94 ± 18.93) hours versus (27.98 ± 19.67) hours] had no significant difference, while pleural effusion decreased significantly (155.22 ± 63.17) ml vs 192.95 ± 61.58 ml, postoperative hospitalization was significantly shorter (7.15 ± 0.58 days vs. 7.93 ± 3.63 days). Conclusion: The right lateral small incision thoracotomy pediatric tetralogy of Fallot curative effect is good, safe and reliable.