同一術者による浅側頭動脈─中大脳動脈吻合術（STA-MCAバイパス）の手術成績と手術手技上の問題点

概要

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Although there are few serious complications with superficial temporal artery-middle cerebral artery (STA-MCA) bypass, the detailed surgical complications are still unclear. We analyzed surgical complications and technical problems in 196 patients who underwent STA-MCA bypass by one surgeon from 2001 to 2011. Furthermore, all operations were equally divided into four stages according to time line (1st, 2nd, 3rd and 4th stages) and analyzed to clarify whether more surgical experience results in better surgical results. Overall surgical morbidity was 2.0% and mortality was 0%, but there were some problems related to STA preparation caused by the surgical technique itself. This study suggested that ischemic complication occurred at the rate of 2–4% and technical problems of STA injury or occlusion occurred in 2–12% of operations. These rates of morbidity and technical problems were almost the same in all periods, even in the last 46 cases. In STA-MCA bypass surgery, training in suturing technique is essential. Furthermore, care must be paid in other procedures, such as STA preparation.
一般社団法人日本脳卒中の外科学会の論文