Department of Neurosurgery, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Neurosurgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon-Si, Republic of Korea.
BMC Surg. 2023 Mar 8;23(1):50. doi: 10.1186/s12893-023-01942-7.
Trans-eyebrow supraorbital aneurysmal neck clipping, also known as keyhole surgery, have many advantages of minimal invasive surgery. However, there are few studies on whether there is a difference in keyhole surgery according to the location of the aneurysm, and how the complications after keyhole approach differ from the conventional approach. The authors investigated the surgical outcome of keyhole aneurysmal surgery for clarify the characteristics of keyhole surgery.
A retrospective study was performed with review of medical records and images of patients with anterior circulation aneurysm undergoing aneurysmal clipping with keyhole surgery. The patient's clinical condition, imaging, surgical condition, and outcome were investigated.
As a result of analysis about the location of the aneurysm, middle cerebral artery (MCA) aneurysm group had a longer operation time than internal carotid artery and anterior cerebral artery aneurysm groups, but there was no significant difference in complication rate. The olfactory dysfunction occurred more than that of conventional surgery and occurred less in MCA aneurysm group than others. Scalp sensory change in the surgical site was more common in patients with unruptured aneurysms.
By accurately investigating the frequency and severity of complications associated with trans-eyebrow aneurysmal neck clipping surgery, it can help to select a surgical approach considering risk versus benefit. In addition, patient's satisfaction can be increased by providing information to patients and caregivers in advance about the outcome of this approach and the anticipated complications.
经眉弓眶上裂动脉瘤颈夹闭术，又称锁孔手术，具有微创的诸多优点。然而，关于根据动脉瘤位置进行锁孔手术是否存在差异，以及锁孔入路后的并发症与传统入路有何不同的研究较少。作者通过研究锁孔动脉瘤手术的手术结果，来阐明锁孔手术的特点。
对接受锁孔手术夹闭前循环动脉瘤的患者的病历和图像进行回顾性研究。对患者的临床状况、影像学、手术情况和结果进行了调查。
根据动脉瘤位置的分析，大脑中动脉（MCA）动脉瘤组的手术时间长于颈内动脉和大脑前动脉动脉瘤组，但并发症发生率无显著差异。嗅觉功能障碍的发生率高于传统手术，MCA 动脉瘤组发生率低于其他组。手术部位头皮感觉改变在未破裂动脉瘤患者中更为常见。
通过准确调查与经眉弓眶上裂动脉瘤颈夹闭术相关的并发症的频率和严重程度，可以帮助在考虑风险与收益的情况下选择手术方法。此外，通过提前向患者和护理人员提供有关此方法的结果和预期并发症的信息，可以提高患者的满意度。
