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Application of hybrid operating rooms for treating spinal dural arteriovenous fistula
BACKGROUND: A hybrid operating room (hybrid-OR) is a surgical space that combines a conventional operating room with advanced medical imaging devices. AIM: To explore and summarize the technical features and effectiveness of the application of a hybrid-OR in dealing with spinal dural arteriovenous f...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Baishideng Publishing Group Inc
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7103968/ https://www.ncbi.nlm.nih.gov/pubmed/32258076 http://dx.doi.org/10.12998/wjcc.v8.i6.1056 |
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author | Zhang, Nai Xin, Wen-Qiang |
author_facet | Zhang, Nai Xin, Wen-Qiang |
author_sort | Zhang, Nai |
collection | PubMed |
description | BACKGROUND: A hybrid operating room (hybrid-OR) is a surgical space that combines a conventional operating room with advanced medical imaging devices. AIM: To explore and summarize the technical features and effectiveness of the application of a hybrid-OR in dealing with spinal dural arteriovenous fistulas (SDAVFs). METHODS: Eleven patients with SDAVFs were treated with the use of a hybrid-OR at the Department of Neurosurgery of our hospital between January 2015 and December 2018. The dual-marker localization technique was used in the hybrid-OR to locate the SDAVFs and skin incision, and the interoperative digital subtraction angiography (DSA) technique was used before and after microsurgical ligation of the fistulae in the hybrid-OR to verify the accuracy of obliteration. The patients were followed for an average of 2 years after the operation, and the preoperative American Spinal Cord Injury Association (ASIA) score and postoperative ASIA score at 6 mo after the operation were compared. RESULTS: The location and skin incision of the SDAVFs were accurately obtained by using the dual-marker localization technique in the hybrid-OR in all patients, and there were no cases that required expansion of the range of the bone window in order to expose the lesions. Intraoperative error obliteration occurred and was identified in two patients by using the intraoperative DSA technique; therefore, the findings provided by the intraoperative DSA system significantly changed the surgical procedure in these two patients. With the assistance of the hybrid-OR, the feeding artery was correctly ligated in all cases, and the intraoperative error obliteration rate decreased from 18.2% (2/11) to 0%. All 11 patients were followed for an average of 2 years. The ASIA score at 6 mo after the operation was significantly improved compared with the preoperative ASIA score, and there were no patients with late recurrence during the follow-up. CONCLUSION: Compared with intra-arterial embolization for the treatment of SDAVFs, hybrid-ORs can solve the problem of a higher incidence of initial failure and late recurrence. Compared with direct occlusion of SDAVFs in microsurgery, hybrid-ORs can take advantage of the intraoperative DSA system for locating the shunt and verifying the obliteration of fistulae in order to reduce the error obliteration rate. At this point, our experience suggests that the safety and ease of use make hybrid-ORs combined with microsurgery and intraoperative DSA systems an attractive modality for dealing with SDAVFs. |
format | Online Article Text |
id | pubmed-7103968 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Baishideng Publishing Group Inc |
record_format | MEDLINE/PubMed |
spelling | pubmed-71039682020-04-02 Application of hybrid operating rooms for treating spinal dural arteriovenous fistula Zhang, Nai Xin, Wen-Qiang World J Clin Cases Retrospective Study BACKGROUND: A hybrid operating room (hybrid-OR) is a surgical space that combines a conventional operating room with advanced medical imaging devices. AIM: To explore and summarize the technical features and effectiveness of the application of a hybrid-OR in dealing with spinal dural arteriovenous fistulas (SDAVFs). METHODS: Eleven patients with SDAVFs were treated with the use of a hybrid-OR at the Department of Neurosurgery of our hospital between January 2015 and December 2018. The dual-marker localization technique was used in the hybrid-OR to locate the SDAVFs and skin incision, and the interoperative digital subtraction angiography (DSA) technique was used before and after microsurgical ligation of the fistulae in the hybrid-OR to verify the accuracy of obliteration. The patients were followed for an average of 2 years after the operation, and the preoperative American Spinal Cord Injury Association (ASIA) score and postoperative ASIA score at 6 mo after the operation were compared. RESULTS: The location and skin incision of the SDAVFs were accurately obtained by using the dual-marker localization technique in the hybrid-OR in all patients, and there were no cases that required expansion of the range of the bone window in order to expose the lesions. Intraoperative error obliteration occurred and was identified in two patients by using the intraoperative DSA technique; therefore, the findings provided by the intraoperative DSA system significantly changed the surgical procedure in these two patients. With the assistance of the hybrid-OR, the feeding artery was correctly ligated in all cases, and the intraoperative error obliteration rate decreased from 18.2% (2/11) to 0%. All 11 patients were followed for an average of 2 years. The ASIA score at 6 mo after the operation was significantly improved compared with the preoperative ASIA score, and there were no patients with late recurrence during the follow-up. CONCLUSION: Compared with intra-arterial embolization for the treatment of SDAVFs, hybrid-ORs can solve the problem of a higher incidence of initial failure and late recurrence. Compared with direct occlusion of SDAVFs in microsurgery, hybrid-ORs can take advantage of the intraoperative DSA system for locating the shunt and verifying the obliteration of fistulae in order to reduce the error obliteration rate. At this point, our experience suggests that the safety and ease of use make hybrid-ORs combined with microsurgery and intraoperative DSA systems an attractive modality for dealing with SDAVFs. Baishideng Publishing Group Inc 2020-03-26 2020-03-26 /pmc/articles/PMC7103968/ /pubmed/32258076 http://dx.doi.org/10.12998/wjcc.v8.i6.1056 Text en ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. |
spellingShingle | Retrospective Study Zhang, Nai Xin, Wen-Qiang Application of hybrid operating rooms for treating spinal dural arteriovenous fistula |
title | Application of hybrid operating rooms for treating spinal dural arteriovenous fistula |
title_full | Application of hybrid operating rooms for treating spinal dural arteriovenous fistula |
title_fullStr | Application of hybrid operating rooms for treating spinal dural arteriovenous fistula |
title_full_unstemmed | Application of hybrid operating rooms for treating spinal dural arteriovenous fistula |
title_short | Application of hybrid operating rooms for treating spinal dural arteriovenous fistula |
title_sort | application of hybrid operating rooms for treating spinal dural arteriovenous fistula |
topic | Retrospective Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7103968/ https://www.ncbi.nlm.nih.gov/pubmed/32258076 http://dx.doi.org/10.12998/wjcc.v8.i6.1056 |
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