背景:近年来,机器人神经外科的发展给患者带来了很多好处,但很少有关于机器人辅助立体脑电图(SEEG)后手术部位感染(SSI)发生的研究。目的收集机器人辅助SEEG近十年来的相关数据,分析手术部位感染的影响因素和经济负担。
方法:收集了2014年1月至2023年12月接受机器人辅助SEEG的所有患者的基本和手术信息。采用Logistic回归分析不同亚组(射频热凝或癫痫切除术)影响SSI的因素。
结果:本研究共纳入242名受试者。癫痫切除手术组(18.1%)发生SSI的风险是射频热凝组(5.1%)的3.5倍(OR3.49,95%CI1.39~9.05),差异有统计学意义。癫痫切除手术组的SSI发生率与较短的手术间隔(≤9天)和较高的BMI(≥23kg/m2)有关(比对照组高6.1和5.2倍,分别)。高血压和入住重症监护病房(ICU)是射频热凝组发生SSI的危险因素。患有SSIs的患者的总住院费用增加了21,231美元,住院7天,术后住院时间比没有SSI的患者长8天。
结论:接受立体脑电图检查后的癫痫切除术患者的SSI发生率高于接受射频热凝治疗的患者。对于接受癫痫切除手术的患者,延长立体脑电图和癫痫切除术的间隔时间可以降低SSI的风险;同时,对于接受射频热凝治疗的患者,如果条件允许,不建议进入ICU进行短期观察。
BACKGROUND: In recent years, the development of robotic neurosurgery has brought many benefits to patients, but there are few studies on the occurrence of surgical site infection (SSI) after robot-assisted
stereoelectroencephalography (SEEG). The purpose of this study was to collect relevant data from robot-assisted SEEG over the past ten years and to analyze the influencing factors and economic burden of surgical site infection.
METHODS: Basic and surgical information was collected for all patients who underwent robot-assisted SEEG from January 2014 to December 2023. Logistic regression was used to analyze the factors influencing SSI according to different subgroups (radiofrequency thermocoagulation or epilepsy resection surgery).
RESULTS: A total of 242 subjects were included in this study. The risk of SSI in the epilepsy resection surgery group (18.1%) was 3.5 times greater than that in the radiofrequency thermocoagulation group (5.1%) (OR 3.49, 95% CI 1.39 to 9.05); this difference was statistically significant. SSI rates in the epilepsy resection surgery group were associated with shorter surgical intervals (≤ 9 days) and higher BMI (≥ 23 kg/m2) (6.1 and 5.2 times greater than those in the control group, respectively). Hypertension and admission to the intensive care unit (ICU) were risk factors for SSI in the radiofrequency thermocoagulation group. Patients with SSIs had $21,231 more total hospital costs, a 7-day longer hospital stay, and an 8-day longer postoperative hospital stay than patients without SSI.
CONCLUSIONS: The incidence of SSI in patients undergoing epilepsy resection after
stereoelectroencephalography was higher than that in patients undergoing radiofrequency thermocoagulation. For patients undergoing epilepsy resection surgery, prolonging the interval between
stereoelectroencephalography and epilepsy resection surgery can reduce the risk of SSI; At the same time, for patients receiving radiofrequency thermocoagulation treatment, it is not recommended to enter the ICU for short-term observation if the condition permits.