Awake craniotomy for brain tumor: indications, technique and benefits

Dziedzic, Tomasz; Bernstein, Mark

doi:10.1586/14737175.2014.979793

Cited by 55 publications

(36 citation statements)

References 98 publications

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“…The details of the surgical procedure, including the incorporation of AC, have been extensively described elsewhere. 15,17 Anesthetic management An intravenous catheter and all standard monitors (electrocardiogram, noninvasive blood pressure, and pulse oximetry) were applied to the patient following arrival in the operating room. 18 Positioning of the patient was determined by the location of the lesion.…”

Section: Surgical Managementmentioning

confidence: 99%

Same-day discharge after craniotomy for supratentorial tumour surgery: a retrospective observational single-centre study

Venkatraghavan

Bharadwaj

et al. 2016

Can J Anesth/J Can Anesth

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Purpose Enhanced Recovery After Surgery is a multimodal perioperative care pathway designed to achieve early discharge in patients undergoing major surgery. Recent advances in neurosurgery allow for shorter duration of anesthesia and surgery, faster recovery, and earlier discharge from hospital. The purpose of this retrospective observational study was to assess the incidence of early discharge from hospital in patients undergoing craniotomy for supratentorial brain tumours as well as to explore the associated perioperative factors, anesthesia techniques, and complications. Methods The medical records of all patients who underwent craniotomy (less than four-hour duration) for supratentorial tumour over a five-year period were retrospectively reviewed. The data analyzed included the postoperative discharge destination, type of anesthesiai.e., general anesthesia (GA) vs awake craniotomy (AC), and the incidence of adverse events. Results Data from 329 patients [mean (SD) age 48 (12) yr; 164 male, 165 female] were analyzed, including 198 (AC, n = 157; GA, n = 41) patients who were preoperatively

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Section: Surgical Managementmentioning

confidence: 99%

Same-day discharge after craniotomy for supratentorial tumour surgery: a retrospective observational single-centre study

Venkatraghavan

Bharadwaj

et al. 2016

Can J Anesth/J Can Anesth

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“…How can one interpret such an improvement? Two major mechanism underlie this improvement: the first is associated with the technical nuances of the neurosurgical operation in which neurosurgeons pay attention to a maximal safe resection during brain tumor removal (see also: Dziedzic & Bernstein 2014;Hervey-Jumper & Berger 2015;Hervey-Jumper SL, Li J, Lau 2015). In other words, individualized surgery in neuro-oncological treatment of GBM is based on the goal of achieving a maximal tumor resection without inducing new neurological deficits (Ghinda, & Duffau 2017;Sanai, Berger 2008;Ahmadi, Dictus, Hartmann et al 2009;McGirt, Chaichana, Attenello et al 2008).…”

Section: Discussionmentioning

confidence: 99%

Health-Related Quality of Life of a Patient Following Neurosurgery on Glioblastoma Multiforme (Gbm)

Morga¹,

Moskała²,

Adamek³

et al. 2018

Acta Neuropsychologica

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Health-related quality of life (HRQoL) plays a role as a patient-centered meaningful endpoint, assessing the direct clinical benefit for a patient. The inclusion of HRQoL measurements in a glioma patient may provide important data to inform clinicians on treatment decision-making. The aim of the study was to evaluate cognitive decline and HRQoL in the clinical care of a patient following neurosurgery on of glioblastoma multiforme (GBM). A 69-year-old female developed malignant brain glioma in the right temporal-occipital area; this being confirmed by CT and MR study and neuropathological findings. She had complained of headaches, dizziness, nausea, vomiting as well as attention and memory loss, and anxiety, sadness and a slowing down in the performance of daily activities. The symptoms rapidly became worse and she was referred to a neurosurgery department for consultation. She was successfully neurosurgically operated on. She was examined with the use of ne uro psycho logical tests three times: the first examination was conducted before the neurosurgical operation, the second two weeks after, and the third half year after the neurosurgical operation. In the first examination by the standard Polish version of the Mindstreams™ Interactive Computer Tests disturbances for all the tested cognitive functions occurred. The greatest changes were to occur however in the areas of visual-spatial functions. attention, executive functions and memory. In the second test, a return to the norm was achieved for the disturbed cognitive and executive functions. In the third examination (half a year after the neurosurgical operation), the cognitive and executive functions were still not bad, but had slightly decreased. Similar trend was observed in HRQoL. A significant difference in the health profile between the 1 st and 2 nd as well as between 1 st and 3 rd examination was detected for the eight SF-36 domains - HRQoL was improved. While only slight but no significant changes occurred between 2 nd and 3 rd examination. HRQoL was still not bad, but had slightly decreased. The patient after the neurosurgical operation of glioblastoma multiforme (GBM) is capable of carrying out daily activities, but shows some level of reduced complains for functional capacity, pain, general health and vitality, emotional and social functioning for mental health which has led to the impaired HRQoL.

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“…[14] Since 1991, the senior author has routinely performed awake craniotomy for intra-axial brain tumors with low complication rates and minimum resource utilization. [9,10,12,31] In 1996, a pilot study was initiated at the senior author's hospital in Toronto to assess the feasibility of performing craniotomy for tumor resection as an outpatient procedure. [13] The results of this study were reported in 2001.…”

Section: Home Carementioning

confidence: 99%

“…[5][6][7][8] With the advent of awake craniotomy and widespread use of electrophysiological monitoring, brain tumor surgery has become safer, and the postoperative recovery quicker. [9][10][11] This has resulted in fewer postoperative complications and patients being discharged earlier. [12] This evolution has also brought forward the realization that prolonged hospital stay predisposes patients to nosocomial infections and thromboembolic complications, and the overall opinion that patients do better at home than they do in the hospital.…”

Section: Introductionmentioning

confidence: 99%

Is outpatient brain tumor surgery feasible in India?

Turel

Bernstein

2016

Neurol India

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The current trend in all fields of surgery is towards less invasive procedures with shorter hospital stays. The reasons for this change include convenience to patients, optimal resource utilization, and cost saving. Technological advances in neurosurgery, aided by improvements in anesthesia, have resulted in surgery that is faster, simpler, and safer with excellent perioperative recovery. As a result of improved outcomes, some centers are performing brain tumor surgery on an outpatient basis, wherein patients arrive at the hospital the morning of their procedure and leave the hospital the same evening, thus avoiding an overnight stay in the hospital. In addition to the medical benefits of the outpatient procedure, its impact on patient satisfaction is substantial. The economic benefits are extremely favorable for the patient, physician, as well as the hospital. In high volume centers, a day surgery program can exist alongside those for elective and emergency surgeries, providing another pathway for patient care. However, due to skepticism surrounding the medicolegal aspects, and how radical the concept at first sounds, these procedures have not gained widespread popularity. We provide an overview of outpatient brain tumor surgery in the western world, discussing the socioeconomic, medicolegal, and ethical issues related to its adaptability in a developing nation.

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Awake craniotomy for brain tumor: indications, technique and benefits

Cited by 55 publications

References 98 publications

Same-day discharge after craniotomy for supratentorial tumour surgery: a retrospective observational single-centre study

Same-day discharge after craniotomy for supratentorial tumour surgery: a retrospective observational single-centre study

Health-Related Quality of Life of a Patient Following Neurosurgery on Glioblastoma Multiforme (Gbm)

Is outpatient brain tumor surgery feasible in India?

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