Department of Neurosurgery, The Second Hospital of Hebei Medical University, 215 West Heping Road, Shijiazhuang 050000, China.
Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, 361 East Zhongshan Road, Shijiazhuang 050017, China; Hebei Province Key Laboratory of Environment and Human Health, 361 East Zhongshan Road, Shijiazhuang 050017, China.
Neurophysiol Clin. 2021 Mar;51(2):111-119. doi: 10.1016/j.neucli.2020.11.001. Epub 2020 Dec 4.
To explore the difference between robot assisted (RA) and stereotactic frame based (SF) stereoelectroencephalography (SEEG) in patients with medically refractory epilepsy.
We undertook a retrospective review of 33 SEEG cases at our center, of which 14 were SF performed from March to October 2018 and 19 were RA performed from November 2018 to December 2019. Detailed review of medical histories and operative records as well as imaging and trajectory plans was carried out for each patient, and the results related to each technique compared. A multiple linear regression model was used to test for variables that significantly influenced placement error.
Compared to the SF group, the RA group had a higher mean number of electrodes per patient (10.7 ± 2.8 versus 6.4 ± 0.8, P < 0.0001) and a significantly shorter mean operative time (127.3 ± 40.7 versus 152.7 ± 13.6 min, P = 0.033). For the RA group, the intracranial implantation length was positively correlated with target point error (p = 0.000), depth error (p = 0.043), and two-dimensional (2D) radial error (p = 0.041). Conversely, skull thickness was negatively correlated with the TP error (p = 0.004), depth error (p = 0.037) and 2D radial error (p = 0.000). We also analyzed the mean entry point, target point, depth and 2D radial errors, the complication rates, and the results of epileptogenic zone (EZ) localization and Engel class. The results showed no difference in these aspects between the SF group and the RA group.
This study suggests that, compared to stereotactic frame based SEEG, robot assisted SEEG is significantly more efficient and comparable in safety and effectiveness.
探索机器人辅助（RA）与立体定向框架（SF）立体脑电图（SEEG）在药物难治性癫痫患者中的差异。
我们对我院 33 例 SEES 病例进行回顾性分析，其中 2018 年 3 月至 10 月进行 SF 检查 14 例，2018 年 11 月至 12 月进行 RA 检查 19 例。对每位患者的病史和手术记录、影像学和轨迹计划进行详细回顾，并对两种技术的结果进行比较。采用多元线性回归模型检验影响放置误差的变量。
与 SF 组相比，RA 组每位患者的平均电极数（10.7±2.8 个比 6.4±0.8 个，P<0.0001）和平均手术时间（127.3±40.7 分钟比 152.7±13.6 分钟，P=0.033）均显著增加。对于 RA 组，颅内植入长度与靶点误差（p=0.000）、深度误差（p=0.043）和二维（2D）径向误差（p=0.041）呈正相关。相反，颅骨厚度与 TP 误差（p=0.004）、深度误差（p=0.037）和 2D 径向误差（p=0.000）呈负相关。我们还分析了平均进入点、靶点、深度和 2D 径向误差、并发症发生率以及致痫区（EZ）定位和 Engel 分级的结果。结果表明，SF 组和 RA 组在这些方面无差异。
与立体定向框架 SEES 相比，机器人辅助 SEES 具有更高的效率，且在安全性和有效性方面无差异。
