Effect of Surgery on the Long-Term Functional Outcome of Moyamoya Disease: A Meta-Analysis

Özet

AIM: To summarize and calculate the accurate rate of good outcome and the prognosis, using a uniform definition of good outcome,evaluating the long-term effect of surgery.MATERIAL and METHODS: Through searching the relevant databases, we included eligible studies measuring outcomes withthe modified Rankin Scale (mRS), Glasgow Outcome Scale (GOS) and Kim’s category. Single group rates were transformedand synthesized to yield the mean weighted probability. Sensitivity analyses were conducted to check the robustness of overalleffect. Subgroup analyses were stratified by study type, population, age phase, presentation, surgical procedure and outcomemeasurement.RESULTS: The overall estimated rate of good outcome was 0.87 (95%CI, 0.84 0.90), with substantial heterogeneity. In the subgroupanalyses, the outcome measured with GOS led to the highest rate of 91%, while Kim’s category had the lowest rate of 82%. Thecombined bypass surgery group resulted in a higher good outcome rate of 0.92 (95%CI, 0.89 0.96) than the indirect bypass groupof 0.83% (95%CI, 0.78 0.88).CONCLUSION: Moyamoya disease after surgical treatment could achieve a good outcome rate of 87%. Kim’s category reflectedthe functional outcome better, resulting in a good outcome rate of 82%. The combined bypass surgery led to better outcomes thanindirect bypass.