gms | German Medical Science

55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

Waterjet dissection versus ultrasonic aspiration in temporal lobe epilepsy surgery: A randomized study

Wasserstrahldissektion versus Ultraschallaspiration in der Chirurgie der Temporallappenepilepsie: eine randomisierte Studie

Meeting Abstract

  • corresponding author Joachim Oertel - Klinik für Neurochirurgie, Krankenhaus Hannover Nordstadt, Hannover
  • J. Piek - Klinik für Neurochirurgie, Universität Rostock, Rostock
  • U. Runge - Klinik für Neurologie, Universität Greifswald, Greifswald
  • H. W. S. Schroeder - Klinik für Neurochirurgie, Universität Greifswald, Greifswald
  • M. R. Gaab - Klinik für Neurochirurgie, Krankenhaus Hannover Nordstadt, Hannover

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocP 09.91

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2004/04dgnc0374.shtml

Veröffentlicht: 23. April 2004

© 2004 Oertel et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

Waterjet dissection is currently under close investigation in neurosurgery. Experimentally, a precise brain parenchyma dissection with vessel preservation has been shown. Clinically, the safety of the instrument has been demonstrated. However, precise data demonstrating that waterjet dissection indeed reduces surgical blood loss are still missing.

Methods

Therefore, the authors applied the waterjet device in a prospective randomized study in comparison with the ultrasonic aspirator in 30 cases of temporal lobe epilepsy surgery between February 2000 and October 2002. All procedures were performed by the senior neurosurgeon. Intraoperative vessel preservation, blood loss, complications as well as surgical outcome were evaluated. All patients received early post operative MRI studies and were followed in 3-month intervals.

Results

Intraoperatively, both instruments were easy to handle. Intra parenchymal blood vessels were preserved only with the waterjet dissector. Intra operative blood loss was significantly reduced with the waterjet (mean 70 cc ± 53 SD) in comparison with the ultrasonic aspirator (mean 121 cc ± 47 SD, fig.1). However, no difference in the necessity for blood transfusion occurred. No difference was observed with respect to operation time (238 min vs. 247 min, fig.2), complications and outcome.

Conclusions

In all, the waterjet dissector enables a significant reduction of intra operative blood loss in this clinical setting. However, further studies have to confirm these results with a larger number of patients. These studies also have to prove that the reduction of blood loss observed is of relevance for the patient’s outcome.