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59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

01. - 04.06.2008, Würzburg

Perioperative complications of craniotomies in pediatric patients with brain tumours

Perioperative Komplikationen bei Kraniotomien pädiatrischer Patienten mit Hirntumoren

Meeting Abstract

Suche in Medline nach

  • corresponding author M. von Lehe - Klinik für Neurochirurgie, Universitätsklinikum Bonn
  • H.-J. Kim - Klinik für Neurochirurgie, Universitätsklinikum Bonn
  • J. Schramm - Klinik für Neurochirurgie, Universitätsklinikum Bonn
  • M. Simon - Klinik für Neurochirurgie, Universitätsklinikum Bonn

Deutsche Gesellschaft für Neurochirurgie. Società Italiana di Neurochirurgia. 59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch). Würzburg, 01.-04.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocMO.08.05

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2008/08dgnc089.shtml

Veröffentlicht: 30. Mai 2008

© 2008 von Lehe et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

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Objective: Perioperative complications following craniotomy for tumour resection in adult patients have been analyzed in considerable detail. Similar data for pediatric patients are lacking. Hence, the authors have reviewed their experience in this latter patient population.

Methods: A retrospective chart review was performed for all patients <16 years undergoing surgery for brain tumours at the author’s institution between March 1989 and July 2006. 235 craniotomies (69.4% supratentorial) were performed in 189 patients (mean 8.5 years). 33 patients (17.5%) had two and 6 (3.2%) three or more craniotomies. We recorded all perioperative complications and neurological outcomes after the first 30 days following surgery.

Results: New deficits occurred after 17/72 (23.6%) posterior fossa, but only after 11/163 (6.7%) supratentorial craniotomies (P<0.001). However, significant worsening of the preoperative performance status (worsening of modified KPI: >20 points) was seen in only 2.6% of the children. There were 6 local infectious complications (2.6%), 4 postoperative bleedings necessitating revision surgery (1.7%), and 9 severe systemic complications (3.8%; pneumonia, sepsis etc.). Surgical mortality was 0.4%. Ventricular shunting or endoscopic ventriculostomy proved necessary in 33/72 (45.8%) of children with posterior fossa tumors, and after 13/163 (8.0%) supratentorial craniotomies (P<0.001).

Conclusions: Local complication rates and neurological outcomes after craniotomy for pediatric patients compare favourably with similar data from adult series. Surgery for posterior fossa tumors carries a relatively increased risk for neurological worsening. Children with infratentorial tumors surprisingly often need a permanent CSF shunt or ventriculostomy. Systemic complications seem to occur less often in the pediatric population. The authors’ data could be used as a reference by those involved in the planning and organisation of pediatric neurosurgical care.