Inflation-deflation method for endoscopic evacuation of intracerebral haematoma
Inflation-deflation method for endoscopic evacuation of intracerebral haematoma
复制标题
DOI：
10.1007/s00701-008-1561-6
复制
发表时间：
2008-07-01
影响因子：
2.4
通讯作者：
Okamoto, T.
中科院分区：
文献类型：
--
作者：
Nagasaka, T.;Inao, S.;Okamoto, T.
背景。内镜下脑内血肿清除术（ICH）具有比开颅手术侵入性较小的优点，但可视化有限和止血困难仍然是一个问题。血肿腔的塌陷限制了手术视野的可视化。用盐水冲洗使血肿腔膨胀可改善可视性并有助于准确的术中定位。方法。腔内充放气法是一种独特的技术，可以帮助探查残余血肿并接近出血点。我们还开发了一种组合式冲洗-凝固吸引管，集中了吸引、冲洗和单极凝固的功能。研究结果。这种多功能专用仪器的使用及其在腔内充放气法中的应用，可以轻松识别残余血肿和出血血管。安全止血也可以在清晰的可视化下完成。手术后任何患者均未出现手术并发症和再出血。我们的结果显示，中位血肿清除率为99%，手术效果令人满意。结论。使用冲洗-凝固吸引管组合的充气-放气方法可以促进 ICH 的最佳排空并确保止血。尽管该手术是否能改善患者的临床结果还需要进一步积累患者并仔细分析，但其应用的初步结果是有希望的。
Background. Endoscopic evacuation of intracerebral haematoma (ICH) has the advantage of being less invasive than craniotomy, but limited visualisation and difficulties in haemostasis are still a concern. The collapse of the haematoma cavity limits the visualisation of the surgical field. Inflation of the haematoma cavity with saline irrigation improves visualisation and facilitates accurate intra-operative orientation.Method. A unique technique, the cavity inflation-deflation method can help in exploring the residual haematoma and accessing the bleeding points. We also developed a combined irrigation-coagulation suction tube that concentrates the capabilities of suction, irrigation and monopolar coagulation.Findings. The use of this multifunctional dedicated instrument and its application in the cavity inflation-deflation method allows for easy identification of residual haematoma and bleeding vessels. Secure haemostasis can also be accomplished under clear visualisation. No surgical complications and rebleeding occurred in any patient following the procedure. Our results show that the median haematoma evacuation rate was 99% and the surgical outcome was satisfactory.Conclusions. The inflation-deflation method using a combined irrigation-coagulation suction tube can facilitate optimal evacuation of ICH with secure haemostasis. Although further accumulation of patients and careful analyses are needed to be known whether this procedure improves the clinical outcomes in the patients, the preliminary results of its application have been promising.