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RESEARCH PRODUCT

The influence of surgical experience on the rate of intraoperative aneurysm repture and its impact on aneurysm treatment outcome.

H.-g Böcher–schwarzAxel PerneczkyE. Van Lindert

subject

AdultMaleMicrosurgerymedicine.medical_specialtyAdolescentTreatment outcomeGlasgow Outcome ScaleWorkloadAneurysm RupturedNeurosurgical ProceduresCentral nervous system diseaseAneurysm ruptureAneurysmRisk FactorsAneurysm treatmentmedicineHumanscardiovascular diseasesChildIntraoperative ComplicationsOnderzoek NeurochirurgieAgedRetrospective StudiesAged 80 and overVascular diseasebusiness.industryInfantIntracranial AneurysmRetrospective cohort studyMiddle Agedmedicine.diseaseSurgeryTreatment OutcomeChild Preschoolcardiovascular systemFemaleSurgeryAneurysm surgeryClinical CompetenceNeurology (clinical)Radiologybusiness

description

Abstract BACKGROUND The influence of surgical experience on the result of aneurysm surgery remains unclear. To determine the impact of surgical experience we considered the occurrence of intraoperative aneurysm rupture (IAR) during microneurosurgery for intracranial aneurysms as an objective factor that could be evaluated. METHODS A retrospective study was performed on 379 consecutive patients with 490 cerebral aneurysms operated upon from 1989 to 1995. RESULTS IAR occurred in 6.7% of aneurysms and 8.7% of patients. There was a direct inverse relationship between the annual caseload of the surgeon and the risk of IAR. New neurological deficits (NND) occurred in 21% of patients with IAR, which accounts for 1.8% of NND in all patients with aneurysms. CONCLUSION Although there seems to be a direct relationship between surgical experience and the risk of IAR, the impact on the overall treatment outcome of cerebral aneurysms is rather limited.

10.1016/s0090-3019(01)00547-xhttp://hdl.handle.net/2066/186940