Factors Influencing Surgical Complications of Intra-Axial Brain Tumours

Abstract

The results from published series concerning surgical complications after craniotomies for brain tumours are not comparable because of the lack of homogeneity between them. The knowledge of the complications rate in each particular neurosurgical department turns out essentially to provide the patient with tailored information about risks before surgery.

Use of topical landmarks for percutaneous projection of intracranial tumors for neurosurgical oncology

“…This method provides smaller chances of encountering unpleasant surprises in the postoperative period along with better orientation for the surgeon. The rate of postoperative deficit following subcortical tumor ablation in our series has been 12.5%, which is comparable with the 13-27.5% postoperative deficit rates reported in the literature (3,4,21,25). The only postoperative complication encountered in cortical tumor ablation in our series has been a transient motor deficit which spontaneously resolved.…”

Short‐term outcomes of craniotomy for malignant brain tumors in the elderly

“…[19][20][21][22] By using samples from patients who underwent resection of both primary and metastatic tumors, 2 studies associated age with an increased risk of major complications. 7,9 Two other studies, which included only patients who had bone metastases, reported an association between age and increased morbidity and mortality. 19,22 In contrast, 2 studies in patients with malignant glioma concluded that advanced age was not associated with increased morbidity, and no association was observed between age and postsurgical neurologic function.…”

“…19,22 In contrast, 2 studies in patients with malignant glioma concluded that advanced age was not associated with increased morbidity, and no association was observed between age and postsurgical neurologic function. 20,21 Major limitations of previous study designs included limited assessment of preoperative and intraoperative factors, single-institution patient samples, 7,9,21,22 small sample sizes with few events, 7,21,22 and reliance on univariate analyses to arrive at the conclusions. 7,13,21,22 We identified a greater prevalence for prolonged LOS among elderly patients across our entire sample; however, there was no significant difference between age groups when we examined total hospital LOS as a continuous variable (Table 2).…”

“…Although a few studies have assessed the role of age on the short-term outcome of patients with a primary or metastatic tumors, these had numerous limitations. 7,9,[19][20][21][22] Because patients aged 75 years (and, in some cases, aged 65 years or !70 years) usually or frequently are excluded from most clinical trials, [13][14][15] there is a paucity of data regarding the risk of definitive surgical resection and its correlation with short-term, perioperative outcomes in these patients. Contrary to common assumptions, our analysis of a large, prospective, multi-institutional database suggests that advanced age does not predispose individuals undergoing aggressive surgical therapy for primary or metastatic intracranial tumor to increased risk for operative or short-term postoperative morbidity or mortality.…”

“…This inequity has been attributed in part to a belief that elderly patients are a more fragile population, unable to tolerate long surgeries, and have a higher risk of morbidity and mortality after craniotomy for malignant tumor resection. [6][7][8][9] The objective of this study was to investigate the effect of advanced age (!75 years), alone and in combination with several preoperative and intraoperative factors, on 30-day outcomes in patients with primary and metastatic brain tumors who underwent craniotomy for the definitive resection of a neoplasm.…”