Outpatient anterior cervical discectomy: A French study and literature review

Gennari, Antoine; Mazas, Simon; Coudert, Pierre; Gille, Olivier; Vital, Jean-Marc

doi:10.1016/j.otsr.2018.04.014

Cited by 19 publications

(44 citation statements)

References 33 publications

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“…Postoperative retropharyngeal (RFH), wound (WH), and/or spinal epidural hemorrhages (SEH) following anterior cervical discectomy/fusion (ACDF), anterior corpectomy fusion (ACF), and/ or anterior cervical spine surgery (ACSS) occur in from 0.4%-1.2% of cases. [1][2][3][4][5][6][7][8][9][10][11] e incidence of postoperative hematomas (HT) was culled from 11 articles involving anterior cervical surgery; 4 single case reports, 2 small case series (6 and 30 cases), 4 larger series (758-2375 for a total of 6729 patients), and the largest series of 37,261 ACDF patients from the NSQUIP Database (National Surgical Quality Improvement Program). [1][2][3][4][5][6][7][8][9][10][11] Our aim was to focus on the frequency, symptom duration/recognition, management, and outcomes of postoperative hematomas following cervical spine surgery.…”

Section: Introductionmentioning

confidence: 99%

Frequency, recognition, and management of postoperative hematomas following anterior cervical spine surgery: A review

Epstein¹

2020

Surgical Neurology International

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Background: We reviewed the frequency, recognition, and management of postoperative hematomas (HT) (i.e. retropharyngeal [RFH], wound [WH], and/or spinal epidural hematomas [SEH]) following anterior cervical discectomy/fusion (ACDF), anterior corpectomy fusion (ACF), and/or anterior cervical spine surgery (ACSS). Methods: Postoperative cervical hematomas following ACDF, ACF, and ACSS ranged from 0.4% to 1.2% in a series of 11 studies involving a total of 44, 030 patients. These included; 4 single case reports, 2 small case series (6 and 30 cases), 4 larger series (758–2375 for a total of 6729 patients), an a large NSQUIP (National Surgical Quality Improvement Program ) Database involving 37,261 ACDF patients. Results: Risk factors contributing to postoperative cervical hematomas included; DISH (diffuse idiopathic skeletal hyperostosis), ossification of the posterior longitudinal ligament (OPLL), therpeutic heparin levels, longer operative times, multilevel surgery, ASA Scores of +/= 3, (American Society of Anesthesiologists), prone surgery, operative times > 4 hours, smoking, higher/lower body mass index (BMI), anemia, age >65, > medical comorbidities, and male gender. Notably, the use of drains did not prevent HT, and did not increase the infection, or reoperation rates. Conclusion: In our review of 11 studies focused on anterior cervical surgery, the incidence of postoperative hematomas ranged from 0.4 to 1.2%. Early recognition of these postoperative hemorrhages, and appropriate management (surgical/non-surgical) are critical to optimize recovery, and limit morbidity, and mortality.

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Section: Introductionmentioning

confidence: 99%

Frequency, recognition, and management of postoperative hematomas following anterior cervical spine surgery: A review

Epstein¹

2020

Surgical Neurology International

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“…Early success with this change in practice has moved brain surgery toward an already established process of outpatient procedures in other specialties/subspecialties. [14-16,18,19] Taken together, it has been demonstrated that these measures can reduce hospital stay, thereby reducing the risk of nosocomial infections as well as being cost effective for both the patient and the system.…”

Section: Discussionmentioning

confidence: 99%

Challenging the myth of outpatient craniotomy for brain tumor in a Sub-Saharan African setting: A case series of two patients in Ibadan, Nigeria

Balogun¹,

Idowu²,

Malomo³

2019

Surg Neurol Int

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Background:The concept of modern neuro-oncology hinges on strategic innovation and refinement of procedures with the intention to enhance safety, optimize extent of tumor resection, and improve not only survival but also the quality of life as well. One of such refinements includes same-day hospital admission, as well as early discharge following brain tumor surgeries. The latter has been further stretched to same-day discharge in particular settings to reduce the risk of nosocomial infections, cut brain tumor surgery costs, and improve patients’ satisfaction. We highlight the challenges and possible benefits of outpatient craniotomy in a sub-Saharan African setting portrayed by the presence of lean resources and a predominant “out of pocket” health-care financing.Case Description:Outpatient craniotomy was performed in two selected patients harboring intra-axial tumors: a right temporal low-grade glioma and a left frontal metastasis. The clinical outcome proved successful at short- and long-term in both patients; complications related to surgery and same-day discharge were not reported.Conclusion:Outpatient craniotomy is practicable and safe in resource-challenged environments and can further make brain tumor surgery cost effective and acceptable in carefully selected patients. Further prospective studies in similar settings but involving larger groups of patients are warranted.

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“…[28] Early success with this change in practice has moved brain surgery toward an already established process of outpatient procedures in other specialties/subspecialties. [14][15][16]18,19] Taken together, it has been demonstrated that these measures can reduce hospital stay, thereby reducing the risk of nosocomial infections as well as being cost effective for both the patient and the system.…”

Section: Discussionmentioning

confidence: 99%

Untitled

2019

Surg Neurol Int

View full text Add to dashboard Cite

Background: e concept of modern neuro-oncology hinges on strategic innovation and refinement of procedures with the intention to enhance safety, optimize extent of tumor resection, and improve not only survival but also the quality of life as well. One of such refinements includes same-day hospital admission, as well as early discharge following brain tumor surgeries. e latter has been further stretched to same-day discharge in particular settings to reduce the risk of nosocomial infections, cut brain tumor surgery costs, and improve patients' satisfaction. We highlight the challenges and possible benefits of outpatient craniotomy in a sub-Saharan African setting portrayed by the presence of lean resources and a predominant "out of pocket" health-care financing.Case Description: Outpatient craniotomy was performed in two selected patients harboring intra-axial tumors: a right temporal low-grade glioma and a left frontal metastasis. e clinical outcome proved successful at short-and long-term in both patients; complications related to surgery and same-day discharge were not reported. Conclusion:Outpatient craniotomy is practicable and safe in resource-challenged environments and can further make brain tumor surgery cost effective and acceptable in carefully selected patients. Further prospective studies in similar settings but involving larger groups of patients are warranted.

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Outpatient anterior cervical discectomy: A French study and literature review

Cited by 19 publications

References 33 publications

Frequency, recognition, and management of postoperative hematomas following anterior cervical spine surgery: A review

Frequency, recognition, and management of postoperative hematomas following anterior cervical spine surgery: A review

Challenging the myth of outpatient craniotomy for brain tumor in a Sub-Saharan African setting: A case series of two patients in Ibadan, Nigeria

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