Surgical Designs of Revascularization for Moyamoya Disease: 15 Years of Experience in a Single Center
Autor: | Sho Okamoto, Kinya Yokoyama, Kuniaki Tanahashi, Atsushi Natsume, Takashi Izumi, Toshihiko Wakabayashi, Masaki Sumitomo, Masahiro Nishihori, Kenji Uda, Yoshio Araki, Takashi Mamiya, Fumiaki Kanamori |
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Rok vydání: | 2020 |
Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.medical_treatment Cerebral Revascularization Revascularization Single Center Neurosurgical Procedures Surgical Flaps Young Adult 03 medical and health sciences Postoperative Complications 0302 clinical medicine Risk Factors Humans Surgical Wound Infection Medicine Effective treatment Postoperative Period Moyamoya disease Child Aged Retrospective Studies business.industry Incidence Incidence (epidemiology) Infant Middle Aged medicine.disease Surgery Stroke Plastic surgery Treatment Outcome medicine.anatomical_structure Child Preschool 030220 oncology & carcinogenesis Scalp Female Neurology (clinical) Moyamoya Disease business 030217 neurology & neurosurgery |
Zdroj: | World Neurosurgery. 139:e325-e334 |
ISSN: | 1878-8750 |
Popis: | Cerebral revascularization surgery has been established as an effective treatment for moyamoya disease. On the other hand, harvesting grafts and tissues to nourish the scalp may increase the risk of postoperative wound-related complications. The purpose of this study was to clarify risk factors for wound-related complications after examining the relationship with the surgical design.We retrospectively analyzed 115 patients who underwent 197 revascularization procedures between October 2004 and March 2019. The design of the revascularization was classified into 6 types, then further classified according to the number of grafts harvested, resulting in 11 subtypes. Incidences of minor and major wound-related complications for the 11 different surgical designs were assessed. The risk of complications from each design was statistically examined. In addition, the yearly transition rate of complications was also investigated.Wound-related complications occurred in 38 of the 195 operations (19.5%), including 10 major events (26.3%) and 28 minor events (73.7%). Significant differences in the incidence of complications were seen according to surgical design (P0.05), with complications significantly more frequent for L(a) double type and L(p) double type and less frequent for L(a) single type and L(p) single type. In addition, significant differences were found in the incidence and degree of complications according to the number of grafts (0-2) (P0.05). The incidence of wound-related complications has clearly decreased since 2015.Wound-related complications were more frequent and tended to become more severe with double-bypass procedures but were clearly improved under a plastic surgery approach. |
Databáze: | OpenAIRE |
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