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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2017; 75(11): 801-808
DOI: 10.1590/0004-282X20170141
Article

Transtemporal amygdalohippocampectomy: a novel minimally-invasive technique with optimal clinical results and low cost

Amigdalo-hipocampectomia transtemporal: técnica minimamente invasiva com ótimos resultados clínicos e baixo custo
Juan Antonio Castro Flores
1   Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Instituto de Psiquiatria, Divisão de Neurocirurgia Funcional, São Paulo SP, Brasil.
,
Felipe Hada Sanders
1   Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Instituto de Psiquiatria, Divisão de Neurocirurgia Funcional, São Paulo SP, Brasil.
,
Eberval Gadelha Figueiredo
1   Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Instituto de Psiquiatria, Divisão de Neurocirurgia Funcional, São Paulo SP, Brasil.
,
Manoel Jacobsen Teixeira
1   Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Instituto de Psiquiatria, Divisão de Neurocirurgia Funcional, São Paulo SP, Brasil.
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ABSTRACT

Mesial temporal sclerosis creates a focal epileptic syndrome that usually requires surgical resection of mesial temporal structures.

Objective: To describe a novel operative technique for treatment of temporal lobe epilepsy and its clinical results.

Methods: Prospective case-series at a single institution, performed by a single surgeon, from 2006 to 2012. A total of 120 patients were submitted to minimally-invasive keyhole transtemporal amygdalohippocampectomy.

Results: Of the patients, 55% were male, and 85% had a right-sided disease. The first 70 surgeries had a mean surgical time of 2.51 hours, and the last 50 surgeries had a mean surgical time of 1.62 hours. There was 3.3% morbidity, and 5% mild temporal muscle atrophy. There was no visual field impairment. On the Engel Outcome Scale at the two-year follow-up, 71% of the patients were Class I, 21% were Class II, and 6% were Class III.

Conclusion: This novel technique is feasible and reproducible, with optimal clinical results.

RESUMO

A esclerose mesial temporal é uma síndrome epiléptica focal que requer ablação de estruturas mesiais temporais.

Objetivo: Descrever e padronizar a técnica operatória e resultados clínicos.

Métodos: Série prospectiva de casos de uma única instituição, realizadas por um único cirurgião, de 2006 a 2012. 120 doentes foram submetidos a amigdalo-hipocampectomia transtemporal por acesso mínimo (keyhole).

Resultados: 55% eram do sexo masculino, 85% apresentavam doença do lado direito. As primeiras 70 cirurgias tiveram um tempo cirúrgico médio de 2,51 horas, e as últimas 50 cirurgias tiveram um tempo cirúrgico médio de 1,62 horas. Houve morbidade de 3,3%. 5% dos doentes apresentaram atrofia leve de músculo temporal. O controle das convulsões foi avaliado com a Escala de Engel no segundo ano de pós operatorio, 71% eram Classe I, 21% Classe II, 6% Classe III.

Conclusão: Esta nova técnica é viável, reprodutível e com resultados clínicos adequados.

Keywords:

anterior temporal lobectomy - epilepsy, temporal lobe - epilepsies, partial

Palavras-chave:

lobectomia temporal anterior - epilepsia do lobo temporal - epilepsias parciais


Publication History

Received: 22 May 2017

Accepted: 20 July 2017

Article published online:
01 September 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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