传统和微创癫痫手术方法的技术现状

IF 1.9 Q3 CLINICAL NEUROLOGY Brain & spine Pub Date : 2024-01-01 DOI:10.1016/j.bas.2024.102755
Fabian Winter , Marie T. Krueger , Daniel Delev , Tom Theys , Dirk MP Van Roost , Kostas Fountas , Olaf E.M.G. Schijns , Karl Roessler
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引用次数: 0

摘要

引言开放性切除手术仍是难治性癫痫的主要治疗方式,但由于其创伤性,通常被认为是最后的选择。研究问题本手稿旨在概述现代癫痫外科手术中的传统和微创手术方法。材料和方法本叙述性综述探讨了癫痫外科手术中的历史、现代和微创手术方法。从 PubMed 和 Scopus 上检索了同行评审发表的文章。本研究只考虑用英语撰写的文章。对癫痫手术中的一系列传统和微创手术方法进行了研究,并总结了它们各自的优缺点。结果讨论了以下方法和技术:癫痫手术中的微创诊断、前颞叶切除术、功能性颞叶切除术、经颞叶、经皮质或颞下途径的选择性杏仁核切除术、与激光间质热疗、射频热凝、立体定向放射外科手术、神经调控、高强度聚焦超声以及包括胼胝体切开术、半球切开术和颞下横断术在内的断裂手术相比,胰岛-小脑皮质切除术的效果更好。讨论和结论了解传统和微创癫痫手术中不同手术方法和策略的利弊可能会改善手术决策树,因为并非所有手术都适合所有患者。
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Current state of the art of traditional and minimal invasive epilepsy surgery approaches

Introduction

Open resective surgery remains the main treatment modality for refractory epilepsy, but is often considered a last resort option due to its invasiveness.

Research question

This manuscript aims to provide an overview on traditional as well as minimally invasive surgical approaches in modern state of the art epilepsy surgery.

Materials and methods

This narrative review addresses both historical and contemporary as well as minimal invasive surgical approaches in epilepsy surgery. Peer-reviewed published articles were retrieved from PubMed and Scopus. Only articles written in English were considered for this work. A range of traditional and minimally invasive surgical approaches in epilepsy surgery were examined, and their respective advantages and disadvantages have been summarized.

Results

The following approaches and techniques are discussed: minimally invasive diagnostics in epilepsy surgery, anterior temporal lobectomy, functional temporal lobectomy, selective amygdalohippocampectomy through a transsylvian, transcortical, or subtemporal approach, insulo-opercular corticectomies compared to laser interstitial thermal therapy, radiofrequency thermocoagulation, stereotactic radiosurgery, neuromodulation, high intensity focused ultrasound, and disconnection surgery including callosotomy, hemispherotomy, and subpial transections.

Discussion and conclusion

Understanding the benefits and disadvantages of different surgical approaches and strategies in traditional and minimal invasive epilepsy surgery might improve the surgical decision tree, as not all procedures are appropriate for all patients.

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来源期刊
Brain & spine
Brain & spine Surgery
CiteScore
1.10
自引率
0.00%
发文量
0
审稿时长
71 days
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