Spindler Philipp, Vajkoczy Peter, Schneider Ulf Christoph
Department of Neurosurgery, Charité - University Medicine Berlin, Germany.
Epilepsy Behav Rep. 2021 Mar 26;15:100437. doi: 10.1016/j.ebr.2021.100437. eCollection 2021.
With increasing use of vagus nerve stimulation (VNS) as an adjunct treatment for drug-resistant epilepsy, revision surgery of VNS grows in importance. Indications for revision surgery are diverse and extend of surgery varies. We report a retrospective review on indications and complications of VNS revision surgery at our center. Of 90 VNS procedures 54.4% were revision surgeries. Among those the vast majority was due to depletion of the battery. The entire system was explanted in 15 patients, due to no beneficial effect detected (n = 4), due to irritating side effects (n = 4), and so further diagnostics could cbe carried out (n = 7). Interestingly in three of the patients who underwent further diagnostics, resective epilepsy surgery was performed. Surgical complications occurred in 8.2%. In our experience, revision surgery of VNS was a frequent and safe procedure. There is a need to carefully reviewthe initial indication for VNS implantation prior to revision surgery.
随着迷走神经刺激术（VNS）作为耐药性癫痫辅助治疗方法的使用日益增加，VNS翻修手术的重要性也日益凸显。翻修手术的适应证多种多样，手术范围也各不相同。我们报告了对本中心VNS翻修手术的适应证和并发症的回顾性研究。在90例VNS手术中，54.4%为翻修手术。其中绝大多数是由于电池耗尽。15例患者取出了整个系统，原因是未检测到有益效果（4例）、存在刺激性副作用（4例）以及需要进一步进行诊断（7例）。有趣的是，在接受进一步诊断的3例患者中，进行了切除性癫痫手术。手术并发症发生率为8.2%。根据我们的经验，VNS翻修手术是一种常见且安全的手术。在进行翻修手术之前，有必要仔细审查VNS植入的初始适应证。
