Artikel
Waterjet dissection versus ultrasonic aspiration in temporal lobe epilepsy surgery: A randomized study
Wasserstrahldissektion versus Ultraschallaspiration in der Chirurgie der Temporallappenepilepsie: eine randomisierte Studie
Suche in Medline nach
Autoren
Veröffentlicht: | 23. April 2004 |
---|
Gliederung
Text
Objective
Waterjet dissection is currently under close investigation in neurosurgery. Experimentally, a precise brain parenchyma dissection with vessel preservation has been shown. Clinically, the safety of the instrument has been demonstrated. However, precise data demonstrating that waterjet dissection indeed reduces surgical blood loss are still missing.
Methods
Therefore, the authors applied the waterjet device in a prospective randomized study in comparison with the ultrasonic aspirator in 30 cases of temporal lobe epilepsy surgery between February 2000 and October 2002. All procedures were performed by the senior neurosurgeon. Intraoperative vessel preservation, blood loss, complications as well as surgical outcome were evaluated. All patients received early post operative MRI studies and were followed in 3-month intervals.
Results
Intraoperatively, both instruments were easy to handle. Intra parenchymal blood vessels were preserved only with the waterjet dissector. Intra operative blood loss was significantly reduced with the waterjet (mean 70 cc ± 53 SD) in comparison with the ultrasonic aspirator (mean 121 cc ± 47 SD, fig.1). However, no difference in the necessity for blood transfusion occurred. No difference was observed with respect to operation time (238 min vs. 247 min, fig.2), complications and outcome.
Conclusions
In all, the waterjet dissector enables a significant reduction of intra operative blood loss in this clinical setting. However, further studies have to confirm these results with a larger number of patients. These studies also have to prove that the reduction of blood loss observed is of relevance for the patient’s outcome.