Prosthesis Used in Microvascular Decompressions: A Multicenter Survey in Japan Focusing on Adverse Events.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Hasegawa Mitsuhiro, Hatayama Toru, Kondo Akinori, Nagahiro Shinji, Fujimaki Takamitsu, Amagasaki Kenichi, Arita Kazunori, Date Isao, Fujii Yukihiko, Goto Takeo, Hanaya Ryosuke, Higuchi Yoshinori, Hongo Kazuhiro, Inoue Toru, Kasuya Hidetoshi, Kayama Takamasa, Kawashima Masatou, Kohmura Eiji, Maehara Taketoshi, Matsushima Toshio, Mizobuchi Yoshihumi, Morita Akio, Nishizawa Shigeru, Noro Shusaku, Saito Shinjiro, Shimano Hirofumi, Shirane Reizo, Takeshima Hideo, Tanaka Yuichiro, Tanabe Hidenori, Toda Hiroki, Yamakami Iwao, Nishiyama Yuya, Ohba Shigeo, Hirose Yuichi, Suzuki Takeya
Аннотация
METHODS: A questionnaire was sent to all members of the Japanese Society for MVDs, and answers were obtained from 59 institutions.
RESULTS: Among a total of 2789 MVDs, 1088 operations for trigeminal neuralgia, 1670 for hemifacial spasm, and 31 others, including 117 reoperations, were performed between April 2011 and March 2014. Nonabsorbable material was used in 96.5% of MVDs, including polytetrafluoroethylene (PTFE) (80.5%), polyurethane (11.9%), expanded PTFE (2.1%), and silk thread (1.47%). The use of absorbable materials, including fibrin glue (87.5%), cellulose (13.5%), gelatin (4,77%), and collagen (1.76%), was reported. The major combinations were PTFE with fibrin glue (58.7%) followed by PTFE alone (7.60%). Eighty-eight AEs in 85 (3.2%) cases were reported among 2672 first operations. AEs included 51 central nervous system dysfunctions, 15 wound infections/dehiscence, and 10 others, which were presumed to be related to the intraoperative procedure. Among relatively high-, moderate-, and low-volume centers, there were no significant differences in the frequency of AEs (P = 0.077). Tissue-prosthesis adhesion and/or granuloma formation were reported in 13 cases of 117 reoperations. The incidence of adhesion-related recurrence was 11.1% of all reoperations.
CONCLUSIONS: The number of AEs was quite low in this survey, and intradural use of any prosthesis reported in this paper might be justified; however, further development of easily handled and less-adhesive prosthesis materials is awaited.