Impact of Surgeon Experience on Postoperative Rehemorrhage in Spontaneous Basal Ganglia Intracerebral Hemorrhage
| Autor: | Zheng-Kai Zhu, Liang-Ming Li, Wei-Biao Lin, Yong-Hua Zhu, Wen-Jian Zheng, Qi-Chang Lin, Wei Liao, Shao-Hua Lin, Jia-Hao Su, Zi-Hui Hu |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Decompressive Craniectomy medicine.medical_specialty Operative Time Postoperative Hemorrhage Neurosurgical Procedures 03 medical and health sciences 0302 clinical medicine Recurrence Retrospective survey Basal ganglia Humans Medicine Spontaneous intracerebral hemorrhage Severe complication Retrospective Studies Intracerebral hemorrhage Surgical approach business.industry Basal Ganglia Hemorrhage Odds ratio Middle Aged medicine.disease Gelatin Sponge Absorbable Hemostasis Surgical Surgery Logistic Models Neurosurgeons 030220 oncology & carcinogenesis Hemostasis Female Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | World Neurosurgery. 131:e402-e407 |
| ISSN: | 1878-8750 |
| Popis: | Background Spontaneous intracerebral hemorrhage (SICH) is of high mortality and morbidity. SICH in the basal ganglia is usually attributed to chronic hypertension. Postoperative rehemorrhage is a severe complication, and it is relative to surgical techniques. Methods A retrospective survey was conducted on 123 patients with basal ganglia SICH who received surgery from January 2015 to January 2019. Postoperative rehemorrhage within 24 hours was recorded. Preoperative clinical parameters, surgeon experience ( 20 years), operation time, surgical approach, and hemostasis technique were recorded and analyzed. Results The total postoperative rehemorrhage rate was 12.2% (15/123). The univariable analysis showed general surgeons had a higher postoperative rehemorrhage rate than experienced surgeons (30.4% vs. 8.6%, respectively; P = 0.068). The operation time (minutes) in experienced surgeons was significantly longer (164.9 ± 53.5 vs. 137.7 ± 30.8, P = 0.016), but they had a higher chance to locate the responsible vessel (74.2% vs. 40.0%, P = 0.001), respectively. Logistic analysis indicated that experienced surgeons significantly reduced the risk of rehemorrhage (odds ratio [OR], 0.242; P = 0.021). Transsylvian approach was a protective factor for postoperative rehemorrhage (OR, 0.291; P = 0.045). Conclusions Surgeons' experience plays the most important role in postoperative rehemorrhage. Surgeons with rich experience were willing to spend more time to achieve definitive hemostasis in operation. The use of a transsylvian approach can significantly reduce the rehemorrhage rate. Packing hemostasis with gelatin sponge may increase complications. |
| Databáze: | OpenAIRE |
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