Surgical Complications of Epilepsy Surgery Procedures : Experience of 179 Procedures in a Single Institute
Surgical Complications of Epilepsy Surgery Procedures : Experience of 179 Procedures in a Single Institute
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DOI：
10.3340/jkns.2008.44.4.234
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发表时间：
2008-10-01
影响因子：
1.6
通讯作者：
Park, Sang Keun
中科院分区：
文献类型：
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作者：
Lee, Jun Ho;Hwang, Yong Soon;Park, Sang Keun
目的：癫痫手术并发症的报道较少。我们调查了我们的数据，目前从神经外科医生的角度来看，癫痫手术的并发症，并比较我们的结果与其他以前的reports.Methods：共179外科手术难治性癫痫（41诊断，138治疗）进行了连续92例（10名成人，82名儿童）在过去的9.2年（2月）。1997年4月。2006年）。他们的医疗记录和放射学检查结果进行了审查，以确定和分析手术并发症。结果：诊断程序包括各种组合的硬膜下网格，硬膜下条，和深度电极。41例诊断性手术中发生4例轻微一过性并发症（4/41=9.8%）。共138例治疗手术包括28例前颞叶切除术，21例其他叶切除术，6例病变切除术，21例顶切除术，13例胼胝体切开术，20例迷走神经刺激术，13例多软膜下横断术和16例半球切除术。26例并发症发生在治疗过程中（26/138=18.8%）。在26例并发症中，21例并发症为一过性和可逆性（轻微; 21/138=15.2%），5例为严重并发症（严重，5/138=3.6%）。5例主要并发症包括1例视野缺损、2例死亡和2例植物人状态。有2个额外的死亡率的情况下，这是不相关的手术本身。结论：我们的研究结果表明，并发症发生率高于以往的其他报告中的轻微并发症，是可比的重大并发症。然而，我们的研究结果显示，相对较高的频率的死亡病例和严重的发病情况下，与其他以前的报告。作者希望强调年轻儿科患者急性术后护理的重要性，以及细致的手术技术，以降低癫痫手术的发病率和死亡率。
Objective : There are a few reports on the complications of surgery for epilepsy. We surveyed our data to present complications of epilepsy surgeries from the neurosurgeon's point of view and compare our results with other previous reports.Methods : A total of 179 surgical procedures for intractable epilepsy (41 diagnostic, 138 therapeutic) were performed in 92 consecutive patients (10 adults, 82 children) during the last 9.2 years (February. 1997-April. 2006). Their medical records and radiological findings were reviewed to identify and analyze the surgical complications.Results : The diagnostic procedures encompassed various combinations of subdural grid, subdural strips, and depth electrodes. Four minor transient complications developed in 41 diagnostic procedures (4/41=9.8%). A total of 138 therapeutic procedures included 28 anterior temporal lobectomies, 21 other lobectomies, 6 lesionectomies, 21 topectomies, 13 callosotomies, 20 vagus nerve stimulations, 13 multiple subpial transections, and 16 hemispherectomies. Twenty-six complications developed in therapeutic procedures (26/138=18.8%). Out of the 26 complications, 21 complications were transient and reversible (minor; 21/138=15.2%), and 5 were serious complications (major, 5/138=3.6%). Five major complications were one visual field defect, two mortality cases and two vegetative states. There were 2 additional mortality cases which were not related to the surgery itself.Conclusion : Our results indicate that complication rate was higher than previous other reports in minor complications and was comparable in major complications. However, our results show relatively high frequency of mortality cases and severe morbidity case compared to other previous reports. The authors would like to emphasize the importance of acute postoperative care in young pediatric patients as well as meticulous surgical techniques to reduce morbidity and mortality in epilepsy surgery.