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

BACKGROUND The influence of surgical experience on the result of aneurysm s urgery remains unclear. To determine the impact of surgical experience we c onsidered the occurrence of intraoperative aneurysm rupture (IAR) during mi croneurosurgery for intracranial aneurysms as an objective factor that coul d be evaluated. METHODS A retrospective study was performed on 379 consecutive patients wit h 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 patien ts with IAR, which accounts for 1.8% of NND in all patients with aneurysms. CONCLUSION Although there seems to be a direct relationship between surgica l experience and the risk of IAR, the impact on the overall treatment outco me of cerebral aneurysms is ;rather limited. (C) 2001 by Elsevier Science I nc.