Does size matter? Minimally invasive approach in pediatric neurosurgery—a review of 125 minimally invasive surgeries in children: clinical history and operative results

Abstract

In conclusion, our study shows that it is possible to achieve surgical results in the pediatric population applying minimal invasive techniques comparable to those described in the literature.

Analysis of factors that influence neurosurgical length of hospital stay among newly diagnosed pediatric brain tumor patients

“…Patient demographics, postoperative complications, clinical, tumor‐related, and treatment‐related variables were compared among the short LOS group (LOS ≤3 days), extended LOS group (LOS ≥20 days), and control group (LOS = 4‐19 days). The mean (SE) LOS for our cohort was 15.3 (1.6) days, which appears higher than the mean LOS of another pediatric cohort from London, UK of 114 patients (8.7 days, range, 1‐21 days) . This discrepancy may be attributed to how the latter cohort only included patients undergoing minimally invasive surgeries.…”

“…Our study also identified tumor location to influence LOS. In keeping with prior findings, we found that patients with posterior fossa tumors had longer hospital stays . The greater prevalence of posterior fossa tumors in the extended LOS may also in part explain why hydrocephalus—a common associated finding in posterior fossa tumor patients—occurred more often in the extended LOS cohort than in the shorter LOS cohort.…”

“…The role of CSF leaks in influencing hospital LOS remains controversial . In the present study, we did not find any association between LOS and CSF leaks.…”

“…7 In contrast to adult brain tumor patients, there is a paucity of literature on factors that influence LOS in pediatric neuro-oncology. The limited available data on LOS in pediatric brain tumor patients have identified postoperative wound infections, 8 posterior fossa tumor resection, 8,9 intraoperative blood loss, and difficult extubation 10 to prolong LOS. The effect of postoperative CSF leaks 8,9 on LOS remains controversial in the pediatric population.…”

Future directions of operative neuro-oncology

“…The goal of this surgical evolution and its current end product 'keyhole' surgery (a series of minimally invasive cranial approaches), was not to perform a small incision and craniotomy for the sake of a small opening, but rather, to access the target lesion while causing the least possible trauma to surrounding structures such as the skin, bone, dura, and most importantly the brain [10]. When used in the appropriate clinical setting, minimally invasive 'keyhole' techniques have similar efficacy as more invasive approaches [11]. Their future use will almost certainly increase as more comparative data on their impact on surgical complications is collected.…”