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首页> 外文期刊>Neurosurgery >Delayed surgical resection reduces intraoperative blood loss for embolized meningiomas.
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Delayed surgical resection reduces intraoperative blood loss for embolized meningiomas.

机译：延迟手术切除可减少栓塞性脑膜瘤的术中失血量。

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OBJECTIVE: Embolization before surgical resection of tumors has been demonstrated to reduce intraoperative blood loss, but the optimal time that should elapse between embolization and tumor resection has not been established. We evaluated whether immediate surgical resection (24 h) was more effective in minimizing intraoperative blood loss. METHODS: We retrospectively analyzed the records for 50 patients with meningiomas who underwent preoperative embolization between 1993 and 1999. We divided the patients into two groups, i.e., those who underwent surgical resection of their meningiomas 1000 ml [median, 475 ml] versus 0% with blood loss of >700 ml [median, 337.5 ml]; P = 0.01). There were no statistically significant differences between the groups with respect to tumor volume, extent of embolization, degree of devascularization, necrosis, duration of surgery, or length of the hospital stay. CONCLUSION: Contrary to previous studies that emphasized a need for tumor removal immediately after embolization, to prevent revascularization, surgical resection of meningiomas should be delayed more than 24 hours after embolization, because there is less intraoperative blood loss.
机译：目的：已证明在手术切除肿瘤之前栓塞可减少术中失血，但尚未确定栓塞与肿瘤切除之间应该经过的最佳时间。我们评估了栓塞后立即手术切除（ 24 h）在减少术中失血方面更有效。方法：我们回顾性分析了1993年至1999年间50例术前栓塞的脑膜瘤患者的记录。我们将患者分为两组，即栓塞后24小时进行手术切除的脑膜瘤患者和接受脑膜瘤手术切除的患者。栓塞后24小时以上手术。比较了两组的栓塞程度，术中失血量，手术时间和住院时间。检查术后病理标本以评估栓塞引起的血管形成和坏死的程度。结果：立即治疗组的术中失血量大于延迟治疗组（29％，失血量> 1000 ml [中位数，475 ml]，0％，失血量> 700 ml [中位数，337.5 ml]; P = 0.01）。两组之间在肿瘤体积，栓塞程度，血运重建程度，坏死，手术时间或住院时间方面无统计学差异。结论：与先前的研究强调需要在栓塞后立即切除肿瘤以防止血运重建相反，由于栓塞术后术中失血较少，因此脑膜瘤的手术切除应延迟至栓塞后24小时以上。

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