The Effect of Surgery Time on Prognosis in Newborns with Meningomyelocele

Öncel, Mehmet Yekta; Оздемир, Рамазан; Kahiloğulları, Gökmen; Yurttutan, Sadık; Erdeve, Ömer; Dilmen, Uğur

doi:10.3340/jkns.2012.51.6.359

Cited by 22 publications

(24 citation statements)

References 17 publications

(20 reference statements)

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“…Spatial and temporal access is chiefly important because the lack of medical resources reduces the accessibility of residents’ access to neurosurgical care. In particular, the accessibility of neurosurgeons in neurosurgical emergencies, such as trauma or vascular, is of utmost importance 12) . The aim of this study is to assess the actual geometrical distribution of neurosurgeons across Korea and to identify possible problem that may arise from such distribution trait.…”

Section: Introductionmentioning

confidence: 99%

Geographic Analysis of Neurosurgery Workforce in Korea

Park

Kim

et al. 2018

J Korean Neurosurg Soc

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ObjectiveIn respect of the health and safety of the public, universal access to health care is an issue of the greatest importance. The geographic distribution of doctors is one of the important factors contributing to access to health care. The aim of this study is to assess the imbalances in the geographic distribution of neurosurgeons across Korea.MethodsPopulation data was obtained from the National Statistical Office. We classified geographic groups into 7 metropolitan cities, 78 non-metropolitan cities, and 77 rural areas. The number of doctors and neurosurgeons per 100000 populations in each county unit was calculated using the total number of doctors and neurosurgeons at the country level from 2009 to 2015. The density levels of neurosurgeon and doctor were calculated and depicted in maps.ResultsBetween 2009 and 2015, the number of neurosurgeons increased from 2002 to 2557, and the ratio of neurosurgeons per 100000 populations increased from 4.02 to 4.96. The number of neurosurgeons per 100000 populations was highest in metropolitan cities and lowest in rural areas from 2009 to 2015. A comparison of the geographic distribution of neurosurgeons in 2009 and 2015 showed an increase in the regional gap. The neurosurgeon density was affected by country unit characteristics (p=0.000).ConclusionDistribution of neurosurgeons throughout Korea is uneven. Neurosurgeons are being increasingly concentrated in a limited number of metropolitan cities. This phenomenon will need to be accounted when planning for a supply of neurosurgeons, allocation of resources and manpower, and the provision of regional neurosurgical services.

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Section: Introductionmentioning

confidence: 99%

Geographic Analysis of Neurosurgery Workforce in Korea

Park

Kim

et al. 2018

J Korean Neurosurg Soc

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“…The current approach to the timing of MMC surgical repair is in favor of early surgery [14,15]. However, it is necessary to have an appropriate time interval to obtain comprehensive information about the patient's clinical condition and to plan surgical reconstruction adequately.…”

Section: Discussionmentioning

confidence: 99%

“…Early aggressive treatment approach in postnatal MMC surgery reduces early morbidity and mortality rates [32]. Oncel et al demonstrated that early surgery (<5 days) shortened hospital stay and antibiotic treatment time and reduced complication rates [14]. In the long term, it is reported that cognitive functions are better, need for long-term care and incidence of urinary incontinence are reduced and it positively affects neurogenic bladder prognosis and thus urinary tract function [33,34,35].…”

Section: Discussionmentioning

confidence: 99%

Does the timing of surgery affect short-term prognosis in newborn infants with meningomyelocele?

Mert

Ökten

2020

Preprint

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Objective: To investigate the effect of postnatal primary repair surgery time on short-term (first 30 days) prognosis in neonates with meningomyelocele (MMC).Methods: The records of meningomyelocele patients treated at Adana City Training and Research Hospital between June 30, 2015 and August 1, 2019 were retrospectively reviewed. Demographic and clinical characteristics, surgical time, hospitalization and antibiotic duration, complications and associated anomalies were recorded.Results: Data of 41 patients were evaluated. The patients were divided into two groups according to the time of surgery. There were 18 patients in the early surgery (≤3 days) group and 23 patients in the late surgery (>3 days) group. There was no difference between groups in terms of birth weight, gestational week, head circumference, sex and type of delivery (p>0.05). The length of hospitalization was 17.2 ± 8.2 in the early surgery group and 24.8 ± 16.1 in the late surgery group (p>0.05). Antibiotic duration was 11.8 ± 7.6 in the early surgery group and 13.8 ± 10.1 in the late surgery group (p>0.05). There was no difference between the two groups between the average size of the MMC sac (5.4±1.1 vs 6.1±2.3, p>0.05). The number of patients with postoperative complications in early surgery group was 8 (44.4%) and in late surgery group was 7 (30.4%), and the number of patients reoperated in the first 30 days in early surgery group was 5 (27.7%) and in late surgery group was 6 (26.1%). The number of patients requiring ventriculoperitoneal shunt (VPS) was 9 (50%) in the early surgery group and 13 (56.5%) in the late surgery group. Surgical complications minor-major dehiscences, CSF leakage, local infection, meningitis and ventriculitis are not statistically different between the groups (p>0.05).Conclusion: Although postnatal early surgical intervention in MMC positively affects short-term outcomes, short-term prognosis is also determined by the presence of associated anomalies, VPS placement time, and rupture of the sac.

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“…Sac repair is suggested to be performed in the first 36 hours; some studies have suggested that a shunt should be placed in a second operation, while some studies have demonstrated that the risk of ventriculitis and shunt infection decreases in cases in which sac repair and VP shunt placement is performed in the same operation (2,7,8). We considered that the best option is to decide according to the condition of the patient and the circumstances.…”

Section: Case Presentationmentioning

confidence: 99%

Thoracic Myelomeningocele with Hydrocephalus And Chiari Type 2 Malformation: A Case Report

Canaz¹,

Baturay²,

Topyalin³

et al. 2017

JAREM

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Neural tube defects (NTDs) are multifactorial midline abnormalities that occur during the neurulation process in embryogenesis. Myelomeningocele is an important abnormality that may indicate the necessity of an emergency intervention. Although myelomeningocele can be seen throughout the all spinal axis, the areas with the most common and least common localizations are the lumbosacral region and thoracic region, respectively. The most common co-abnormalities have been reported to be hydrocephalus and Chiari type 2 malformations. There are some differences in the management regarding to the order and the timing of the surgery in myelomeningocele associated with hydrocephalus and Chiari malformations. Here we discuss our management of a rare case of thoracic myelonmeningocele associated with hydrocephalus and Chiari type 2 malformation.

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The Effect of Surgery Time on Prognosis in Newborns with Meningomyelocele

Cited by 22 publications

References 17 publications

Geographic Analysis of Neurosurgery Workforce in Korea

Geographic Analysis of Neurosurgery Workforce in Korea

Does the timing of surgery affect short-term prognosis in newborn infants with meningomyelocele?

Thoracic Myelomeningocele with Hydrocephalus And Chiari Type 2 Malformation: A Case Report

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