The Advantages Of Hybrid Operating Room For Treatment Of Common Nerve Vascular Diseases And The Diagnosis And Treatment Program

Objective: Hybrid Operating Room is a new operating room witch is a integration of imaging diagnostic techniques,endovascular interventional therapy and surgical technology.It is also a "one-stop" clinics platform witch offers all services including diagnosis,treatment decisions,surgery operation and postoperative test in a single setting.Hybrid Operating Room,the international advanced platform,increasingly favored by surgeons,but there is still lack of experience about application of Hybrid Operating Room and neurosurgical treatment of diseases in it.Our aim is to summarize three-year-works and to explore the value of Hybrid operating room in the field of neurosurgery.Methods: Patients treated in the hybrid operating room of the Department of Neurological Surgery at Tianjin Medical University General Hospital between 2011 and 2014 were collected and classified.The clinical data related to neurosurgical treatment were retrospectively analyzed.There were 2399 cases of patients treated in Hybrid operating room,including 817 cases of neurosurgery patients,general surgery 1145 cases,152 cases of cardiac surgery,orthopedics 80 cases,60 cases of Obstetrics and Gynecology,a total of 145 cases of other departments.We carried out 76 cases of intracranial aneurysm,intracranial aneurysm embolization 137 cases,59 cases of vertebral artery stenosis,spinal dural arteriovenous fistula(SDAVFs)and other 21 cases of spinal vascular malformation surgery,two cases surgery of foreign body in the eyes,arteriovenous malformation embolization in 27 cases,arteriovenous fistula embolization seven cases,the internal carotid artery disease treatment C1-C4 segment 181 cases(168 cases the treatment of carotid artery stenosis,carotid surgery six cases of injuries,neck three cases of carotid body tumor surgery,internal carotid artery occlusion open surgery four cases),and the remaining surgery and 307 cases of spinal angiography or cerebral angiography in Hybrid operating room.All of our patients had a three-month to 36-month follow-up.In the analysis of the course of treatment for each patient,we have summarized the various disease diagnosis and treatment process.Results: 3 patients of carotid body tumors(CBT)all achieved a complete resection of the tumor with arterial reconstruction,with no cerebral infarction,no case of tumor recurrence during follow-up,and no side carotid surgery artery stenosis and other complications;168 patients of internal carotid artery stenosis,including 164 cases of carotid artery stenting(CAS),4 carotid endarterectomy(CEA);4 cases of internal carotid artery occlusion opened,two cases of surgical success,two cases failed;6 cases of carotid artery injury,carotid and intracranial foreign body completely removed.All of them had a three-month to 36-month follow-up.Modified Rankin Scale in patients with intracranial aneurysms evaluate postoperative recovery,69 cases had follow-up,seven cases were loss of follow-up,53 patients with good recovery(mRS 0 points),11 patients with mild neurological symptoms(mRS 1 points),three patients of severe disability(mRS 5 points),2 patients died(mRS 6 points).No signs of SDAVF relapse,cerebrospinal fluid leaks,or wound infections were observed during the 3-36-month follow-up.No patients required repeat embolization or surgery,and all(100%)had good outcomes.Conclusion: Ttreating ICA occlusion in hybrid operating room is safer and more efficient.Additionally,postoperative angiography can ensure effective recanalization.Complications occurring during endovascular embolization can be quickly resolved by performing surgery.Use of the hybrid operating room makes diagnosis and treatment safer and more efficient.Treating SDAVFs in the hybrid operating room is safer and more efficient and enables better positioning.Additionally,intraoperative angiography can shorten the operative time and reduce the operative area,while postoperative angiography can ensure effective fistula occlusion.Complications occurring during endovascular embolization can be quickly resolved by performing surgery.Use of the hybrid operating room makes diagnosis and treatment safer and more efficient.