Abstracts

COMPARISON OF SHORT-TERM HEALTHCARE UTILIZATION AFTER STANDARD TEMPORAL RESECTION TO STEREOTACTIC LASER ABLATION FOR MESIAL TEMPORAL LOBE EPILEPSY

Abstract number : 2.175
Submission category : 9. Surgery
Year : 2013
Submission ID : 1743489
Source : www.aesnet.org
Presentation date : 12/7/2013 12:00:00 AM
Published date : Dec 5, 2013, 06:00 AM

Authors :
E. Faught, S. L. Helmers, R. Gross, J. Willie

Rationale: Stereotactic MRI-guided laser ablation (SLA) is a relatively new technique for treatment of refractory temporal lobe epilepsy (TLE). While standard resections for TLE are highly effective, offering up to 80% of patients improvements in seizure control, they carry some risk of morbidity and are resource-intensive in the immediate postoperative period. We compared the hospital course and 30-day morbidity for 9 patients who underwent mesial temporal resection to 9 patients who underwent laser ablation of mesial temporal lesions.Methods: Charts of patients undergoing surgical treatment of mesial TLE between 8/2011 and 11/2012 at Emory University Hospital were reviewed for details of the presurgical workup, postoperative level and length of care, and 30-day morbidity including readmissions to emergency department or hospital. Nine underwent mesial temporal resections and 9 stereotactic laser ablations. Results: Eight of 9 patients in each group had visible lesions on MRI; mesial temporal sclerosis in 8 of the SLA group and in 6 of the resection group. The median length of stay (LOS) for SLA-treated patients was 1 day, mean 1.6 days. For standard resection patients,median LOS was 4 days, mean 5.6 days. Mean intensive care time was 0.3 days for SLA and 1.6 days for standard resections. One complication occurred in each group, a hemianopic visual field defect in an SLA patient and meningitis in a standard resection patient. The rate of 30-day readmissions or ED visits did not differ: 4 in each group. Conclusions: Patients with mesial TLE treated by stereotactic MRI-guided laser ablation required shorter and less intensive postoperative care than those treated by standard temporal lobe resection.More data are needed to compare outcomes for seizure improvement and morbidity, and to determine which preoperative parameters are best suited to each approach.
Surgery