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立体定向脑电图(SEEG)是针对难治性癫痫患者的一项术前评估手段,可定位致痫灶及可能相关的功能皮质区的解剖位置。避免大骨瓣开颅术及其植入精确性,SEEG可能减少相关并发症。然而,由于植入并发症相对较高,颅内电极被认为是具有过度侵入性的操作。此前并无关于SEEG并发症的系统文献综述及Meta分析。该研究的目的是定量回顾文献中SEEG电极植入后各种手术并发症的发生率并进行汇总评估,以便内科医生能够就该术外侵入性监测的相关潜在并发症提供准确建议。此项系统评价是基于PRISMA实现的。通过检索MEDLINE,Scopus,Web of Science数据库,用逆方差加权的固定效应模型对并发症的发生率进行分析。Meta分析与森林图的制作都是通过成熟的制表软件完成的。主要结局指标是总效应量及其95%置信区间(CI)。检索到的1 901篇文献,除重787篇后,通过标题和摘要对1 114篇文章进行了筛选。在这一阶段,排除了没有提及SEEG术后并发症或未达到纳入标准的研究。在排除1 057篇文献后,对剩余的57篇文献进行全文阅读以确定合格标准。最常见的并发症是出血[合并患病率1.0%,95%CI(0.6,1.4)]或感染[合并患病率0.8%,95%CI(0.3,1.2)]。确定了5例死亡[合并患病率0.3%,95%CI(0.1,0.6)]。文章分析确定了与SEEG植入和监测相关的121例手术并发症[合并患病率1.3%,95%CI(0.9,1.7)]。对SEEG相关并发症的实际发生率的综合评估。相比其他术外侵入性监测方法,SEEG并发症的发生率实际上更低。这些数据可能减轻一些关于“立体定位”方法的安全性的担忧,在选择不同的侵入性监测方法时做出更好的决策,并减轻深度电极植入相关的恐惧。
Stereotactic electroencephalography (SEEG) is a preoperative assessment of patients with refractory epilepsy that locates the anatomic location of an epileptogenic zone and possibly a functional cortical area. Avoid large craniotomy craniotomy and its implants accuracy, SEEG may reduce the associated complications. However, the intracranial electrode is considered to be an over invasive procedure due to the relatively high implant complications. There was no systematic literature review and meta-analysis of the complications of SEEG. The purpose of this study was to quantitatively review and summarize the incidence of various surgical complications following SEEG electrode implantation in the literature so that physicians can provide accurate recommendations regarding the potential complications associated with this invasive technique. This systematic review is based on the PRISMA implementation. The incidence of complications was analyzed by searching the MEDLINE, Scopus, Web of Science databases using a fixed-effect model with inverse variance. Meta-analysis and forest diagram production are done through sophisticated tabulation software. The primary outcome measure is the total effect amount and its 95% confidence interval (CI). A total of 1 901 articles were retrieved and 114 articles were screened by titles and abstracts after weighing 787 articles. At this stage, studies that did not refer to postoperative SEEG complications or did not meet the inclusion criteria were excluded. After excluding 1 057 articles, the remaining 57 articles were read in full to determine the eligibility criteria. The most common complication was bleeding [pooled prevalence 1.0%, 95% CI (0.6,1.4)] or infection [pooled prevalence 0.8%, 95% CI (0.3,1.2)]. Five deaths were identified [with a prevalence of 0.3%, 95% CI (0.1, 0.6)]. The article analysis identified 121 surgical complications associated with SEEG implantation and monitoring [with a prevalence of 1.3%, 95% CI (0.9, 1.7)]. A comprehensive assessment of the actual incidence of SEEG-related complications. The incidence of SEEG complications is actually lower than other methods of invasive monitoring. These data may alleviate some concerns about the safety of the “stereotaxic” method, make better decisions when choosing different invasive monitoring methods, and mitigate the fears associated with deep electrode implantation.