Department of Vascular Surgery, Medical Spectrum Twente, Enschede, the Netherlands; TechMed Centre, Faculty of Science and Technology, University of Twente, Enschede, the Netherlands.
Department of Vascular Surgery, Medical Spectrum Twente, Enschede, the Netherlands.
J Vasc Surg. 2019 Dec;70(6):1927-1934.e2. doi: 10.1016/j.jvs.2019.01.071. Epub 2019 Jul 18.
A hybrid operating theater (HOT) enables optimal image quality, improved ergonomics, and excellent sterility for complex endovascular and hybrid procedures. We hypothesize that the commissioning of a new HOT involves a learning curve. It is unclear how steep the learning curve of these advanced HOTs is. The main purpose of this research was to evaluate radiation exposure parameters in a new HOT for a team of vascular surgeons experienced with infrarenal endovascular aneurysm repair (EVAR) procedures in a conventional operating room with a mobile C-arm. In addition, a comparison of the dose-area product (DAP) achieved in this study and in the literature was made.
Before commissioning of the HOT, four vascular surgeons completed a comprehensive HOT training program. From the commissioning of the HOT, clinical and procedural data for all consecutive acute and elective patients treated with EVAR were retrospectively collected for a period of 18 months (January 2016-June 2017). A literature review was conducted of the dose-area product in EVAR procedures performed with a dedicated fixed system or mobile C-arm to analyze how this study performed compared with the literature.
In the 18-month study period, 77 patients were treated with EVAR (59 electively and 18 acutely), from whom the data were obtained. There was no significant change in radiation exposure parameters over time. From the commissioning of the HOT, EVAR procedures were performed with radiation exposure parameters similar to those of studies found in experienced vascular centers using fixed systems.
Concerning radiation exposure parameters, the commissioning of a new HOT was not accompanied by a learning curve. Radiation exposure parameters achieved in this study were similar to those of studies from experienced and dedicated vascular centers.
杂交手术室（HOT）能够实现最佳的图像质量、改善手术者舒适度并为复杂的血管内和杂交手术提供卓越的无菌环境。我们假设，新 HOT 的启用涉及学习曲线。目前尚不清楚这些先进 HOT 的学习曲线陡峭程度如何。本研究的主要目的是评估在新 HOT 中，一组经验丰富的血管外科医生在配备移动 C 臂的传统手术室中进行肾下血管内动脉瘤修复（EVAR）手术时的辐射暴露参数。此外，还比较了本研究中获得的剂量面积乘积（DAP）与文献中的值。
在启用 HOT 之前，四位血管外科医生完成了全面的 HOT 培训计划。从启用 HOT 开始，回顾性地收集了所有连续接受 EVAR 治疗的急性和择期患者的临床和手术数据，时间为 18 个月（2016 年 1 月至 2017 年 6 月）。进行了文献综述，分析了使用专用固定系统或移动 C 臂进行 EVAR 手术的剂量面积乘积，以评估本研究与文献的比较情况。
在 18 个月的研究期间，有 77 名患者接受了 EVAR 治疗（59 例为择期手术，18 例为急性手术），从这些患者中获得了数据。随着时间的推移，辐射暴露参数没有明显变化。从启用 HOT 开始，EVAR 手术的辐射暴露参数与使用固定系统的经验丰富的血管中心的研究结果相似。
在辐射暴露参数方面，新 HOT 的启用并没有伴随着学习曲线。本研究中获得的辐射暴露参数与经验丰富且专门的血管中心的研究结果相似。
