Early postoperative perils of intraventricular tumors: An observational comparative study.

Schär, Ralph; Schwarz, Christa; Soell, Nicole; Raabe, Andreas; Z'Graggen, Werner Josef; Beck, Jürgen (2018). Early postoperative perils of intraventricular tumors: An observational comparative study. World neurosurgery, 113, e769-e776. Elsevier 10.1016/j.wneu.2018.02.177

[img] Text
PIIS1878875018304509.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (5MB) | Request a copy

OBJECTIVE Early postoperative patient surveillance after removal of intraventricular tumors is often hindered by delayed awakening and prolonged somnolence. The objective of this study was to analyze the incidence of early critical postoperative events after elective craniotomies for intraventricular tumors in adults as compared to extraventricular lesions. METHODS An observational comparative study was conducted on adult patients who had undergone first-time elective craniotomies from November 2011 until August 2016. Patients were stratified into extraventricular lesions (group 1) and intraventricular tumors (group 2). The rates of late extubation, early postoperative seizures, emergency head CTs, and urgent surgical intervention within 48 hours and mortality within 30 days of surgery were analyzed from a prospective database. RESULTS A total of 977 elective craniotomies were analyzed: group 1 (951 patients, 97.3%) vs. group 2 (26, 2.7%). In group 2 emergency CTs were significantly more often ordered (rate 34.6 % vs. 8.4%; OR 5.76, 95% CI 2.49-13.35, p = 0.0002), and the incidence of urgent surgical intervention was significantly higher (rate 11.5% vs. 0.8%; OR 15.38, 95% CI 3.83-61.72, p = 0.002) than in group 1. Main reason for urgent surgical intervention in group 2 was acute obstructive hydrocephalus. Overall surgical mortality after 30 days was 0.3% (3 cases in group 1, no case in group 2). CONCLUSION Intraventricular tumors are at significantly higher risk for early emergency head CT and urgent surgical intervention. This patient cohort might benefit from routine intra- and early postoperative imaging, as well as intraoperative extraventricular drain placement.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery

UniBE Contributor:

Schär, Ralph; Schwarz, Christa; Soell, Nicole; Raabe, Andreas; Z'Graggen, Werner Josef and Beck, Jürgen

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1878-8750

Publisher:

Elsevier

Language:

English

Submitter:

Nicole Söll

Date Deposited:

12 Apr 2018 14:50

Last Modified:

26 Oct 2019 21:34

Publisher DOI:

10.1016/j.wneu.2018.02.177

PubMed ID:

29524718

Uncontrolled Keywords:

brain neoplasms cerebral ventricle neoplasms craniotomy postoperative complications

BORIS DOI:

10.7892/boris.113857

URI:

https://boris.unibe.ch/id/eprint/113857

Actions (login required)

Edit item Edit item
Provide Feedback