RT期刊文章SR电子T1半球儿科耐药性癫痫手术技术的比较:个体患者数据荟萃分析乔摩根富林明神经病学神经病学FD Lippincott Williams &威尔金斯10.1212 SP / WNL。首页0000000000207425 10.1212 / WNL。0000000000207425 A1 Jia-Shu陈A1威廉·b·哈里斯A1凯瑟琳·j·吴A1 h . Westley菲利普斯A1 Chi-Hong曾A1亚历山大·g·威尔A1咏叹调Fallah年2023 UL //www.ez-admanager.com/content/early/2023/05/18/WNL.0000000000首页207425.abstract AB目的:半球手术有效治疗unihemispheric小儿癫痫耐药(DRE)切除或断开时癫痫半球。修改原解剖大脑半球切除术生成多个功能等效,disconnective技术进行半球手术,称为功能性hemispherotomy。而无数hemispherotomy变异存在,所有的点都可以分类根据解剖平面中执行,包括垂直方法达到或接近两半球间的裂缝和横向方法达到或接近大脑侧裂。个体患者数据的荟萃分析(IPD)旨在比较癫痫hemispherotomy之间的疗效与并发症的方法更好地描述他们的相对有效性和安全性在现代神经外科治疗小儿衣服给新兴证据表明他们之间的结果可能不同。方法:CINAHL、Embase PubMed和Web的科学搜查了从开始到9月9日,2020年研究报告IPD儿科患者DRE半球手术。最后随访结果感兴趣的是没收自由,time-to-seizure复发和并发症包括脑积水,感染,和死亡率。卡方检验比较自由和并发症发作的频率。多变量mixed-effects Cox回归控制癫痫发作的预测结果进行倾向评分匹配病人比较time-to-seizure之间的递归方法。为可视化kaplan - meier曲线差异time-to-seizure复发。结果:55研究报告686独特的儿科患者半球手术包括荟萃分析。 Among the hemispherotomy subgroup, vertical approaches had greater seizure freedom rates (81.2% vs. 70.7%, p=0.014) than lateral approaches. While there were no differences in complications, lateral hemispherotomy had higher rates of revision hemispheric surgery due to incomplete disconnection and/or recurrent seizures than vertical hemispherotomy (16.3% vs. 1.2%, p<0.001). After propensity-score matching, vertical hemispherotomy approaches independently conferred longer time-to-seizure recurrence than lateral hemispherotomy approaches (HR=0.44, 95%-CI=0.19-0.98).Conclusions: Among functional hemispherotomy techniques, vertical hemispherotomy approaches confer more durable seizure freedom than lateral approaches without compromising safety. Future prospective studies are required to definitively determine whether vertical approaches are indeed superior and how it should influence clinical guidelines for performing hemispheric surgery.