Laser interstitial thermal therapy in the management of bottom-of-sulcus dysplasia-related epilepsy

IF 4.4 2区 医学 Q1 CLINICAL NEUROLOGY
Bowen Yang, Chao Zhang, Xiu Wang, Baotian Zhao, Jiajie Mo, Weiyuan Luo, Xiaoqiu Shao, Jianguo Zhang, Kai Zhang, Wenhan Hu
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引用次数: 0

Abstract

Objective

This study assessed the efficacy and safety of magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) versus open surgery (OS) for the treatment of patients with bottom-of-sulcus dysplasia (BOSD)-related epilepsy.

Methods

Twenty-two patients underwent MRgLITT, while 39 underwent OS. Postoperative seizure-free rates were analyzed using Kaplan–Meier curves. The removal ratio, which represents the extent of damage, was calculated based on preoperative lesion volume and postoperative removal volume. Other outcomes, including adverse events, operative time, and hospital stay, were also compared.

Results

Kaplan–Meier curves indicated the seizure-free rates were comparable between the MRgLITT group (90.9%, 26.5 [23.0, 35.1] months) and OS group (89.7%, 25.2 [16.2, 34.6] months) at the final follow-up (p = 0.901, log-rank test). The removal ratio of MRgLITT (1.3 [1.1, 1.7]) was significantly lower (p = 0.007) than that of OS (5.8 [3.6, 8.5]). A comparison of postoperative neurological deficits, infection rates, and fever rates revealed no significant differences between MRgLITT and OS groups. The operative time (hours) of MRgLITT (3.0, [2.1, 4.9]) was significantly shorter (p = 0.007) than that of OS (3.5 [3.0, 4.5]). The hospital stay (days) after MRgLITT (6 [5.0, 7.5]) was significantly shorter (p < 0.001) than that of OS (11.0 [9.0, 13.5]).

Interpretation

MRgLITT has advantages over OS, including comparable seizure control and adverse event profiles, along with reduced removal ratios, shorter operative time, and shorter hospital stays.

Abstract Image

激光间质热疗法治疗底沟发育不良相关性癫痫。
目的:本研究评价磁共振引导激光间质热疗法(MRgLITT)与开放手术(OS)治疗底沟发育不良(BOSD)相关癫痫患者的疗效和安全性。方法:MRgLITT 22例,OS 39例。采用Kaplan-Meier曲线分析术后无癫痫发作率。根据术前病变体积和术后切除体积计算切除率,切除率代表损伤程度。其他结果,包括不良事件、手术时间和住院时间,也进行了比较。结果:Kaplan-Meier曲线显示,MRgLITT组(90.9%,26.5[23.0,35.1]个月)和OS组(89.7%,25.2[16.2,34.6]个月)在最终随访时无癫痫发作率具有可比性(p = 0.901, log-rank检验)。MRgLITT的去除率(1.3[1.1,1.7])显著低于OS (5.8 [3.6, 8.5]) (p = 0.007)。术后神经功能缺损、感染率和发热率的比较显示MRgLITT组和OS组之间无显著差异。MRgLITT组(3.0,[2.1,4.9])的手术时间(h)明显短于OS组(3.5 [3.0,4.5])(p = 0.007)。MRgLITT(6[5.0, 7.5])后的住院时间(天)显著缩短(p)解释:MRgLITT优于OS,包括可比较的癫痫发作控制和不良事件概况,以及更低的移除率、更短的手术时间和更短的住院时间。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Annals of Clinical and Translational Neurology
Annals of Clinical and Translational Neurology Medicine-Neurology (clinical)
CiteScore
9.10
自引率
1.90%
发文量
218
审稿时长
8 weeks
期刊介绍: Annals of Clinical and Translational Neurology is a peer-reviewed journal for rapid dissemination of high-quality research related to all areas of neurology. The journal publishes original research and scholarly reviews focused on the mechanisms and treatments of diseases of the nervous system; high-impact topics in neurologic education; and other topics of interest to the clinical neuroscience community.
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