Heppner Peter
Department of Pediatric Neurosurgery, Starship Children's Hospital, Auckland, New Zealand.
Childs Nerv Syst. 2025 Jan 7;41(1):86. doi: 10.1007/s00381-024-06710-3.
In this study, we aimed to define the scope of paediatric epilepsy surgery performed in Asia and Australasia.
Representative surgeons from each county were emailed a survey about paediatric epilepsy surgery as it is practiced in their country. The survey covered topics including what investigations, operations and number of surgeries are performed and by whom (adult or paediatric neurosurgeons).
Epilepsy surgery programmes are for the most part more common in larger countries and countries with a higher gross domestic product (GDP). Countries performing epilepsy surgery commonly have access to the full range of investigations except magneto-encephalography (MEG). Intraoperative electrocorticography (ECOG) and stereotaxy are typically available and most have access to extra-operative monitoring. There is limited availability of laser interstitial therapy (LIT) and responsive neuro-stimulation (RNS). China performs approximately 4000 paediatric epilepsy cases per year which is more than all of the other countries combined. Epilepsy surgery case numbers range from 0.2 to 22/ million population per year, and there is a correlation between the number of cases performed and the countries' GDP. A large number of children have no access to epilepsy surgery.
There is a wide variation in access to epilepsy surgery in Asia and Australasia. Some counties have surgical numbers comparable with high volume Western countries, while hundreds of millions of children have no access to surgery at all.
在本研究中，我们旨在明确亚洲和澳大拉西亚地区小儿癫痫手术的开展范围。
我们通过电子邮件向每个国家的代表性外科医生发送了一份关于其所在国家小儿癫痫手术开展情况的调查问卷。该调查涵盖的主题包括进行了哪些检查、手术及手术数量，以及由谁（成人或小儿神经外科医生）进行手术。
癫痫手术项目在大多数情况下，在较大的国家以及国内生产总值（GDP）较高的国家更为常见。开展癫痫手术的国家通常能够进行除脑磁图（MEG）之外的所有检查。术中皮质脑电图（ECOG）和立体定向技术通常可用，并且大多数能够进行术中监测。激光间质热疗（LIT）和反应性神经刺激（RNS）的应用有限。中国每年进行约4000例小儿癫痫手术，这比所有其他国家的总和还多。癫痫手术病例数每年在每百万人口0.2至22例之间，并且手术病例数与国家的GDP之间存在相关性。大量儿童无法接受癫痫手术。
亚洲和澳大拉西亚地区在癫痫手术的可及性方面存在很大差异。一些国家的手术数量与西方高手术量国家相当，而数以亿计的儿童根本无法接受手术。
