Artikel
Routine postoperative CT scans after elective craniotomies for resection of supratentorial tumours – necessary or dispensable?
Postoperative Routine CT-Untersuchungen nach elektiven Kraniotomien zur supratentoriellen Tumorresektion: notwendig oder entbehrlich?
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Veröffentlicht: | 25. Mai 2022 |
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Gliederung
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Objective: Postoperative CT scans are performed routinely after elective craniotomies for tumor resection to detect possible complications early. In most instances, these scans may show unspecific postoperative findings (air, etc.) but have no consequences otherwise. To obtain such scans patients need to be transported to the CT unit and they cause extra costs. We therefore investigated, which preexisting factors or which circumstances seen in these CT scans could lead to consequences like surgery or special treatment on the ICU.
Methods: We retrospectively investigated the postoperative CT scans and clinical data of all patients, which were at least 12 years old at the time of surgery, undergoing an elective craniotomy for supratentorial tumor surgery over a 1-year period. CT scans were routinely obtained 6 hours after surgery. We reviewed all radiological and medical records of these patients.
Results: We identified 120 patients with a mean age of 60 years (range 12-90 years) at the time of surgery. All of these patients had a CT scan about six hours postoperatively. CT scans showed pathological findings in 5 patients (4.1%). Clinical symptoms paralleled the pathological CT-findings in 3 of 5 of these patients. In only one patient (73-year-old woman) with a venous infarction and hemorrhage emergency surgery was necessary. In three patients with cerebral metastases, postoperative hemorrhage was found in the operation field. These patients had a second CT to control for enlargement of the bleedings.
Conclusion: Our study shows that routine postoperative CT scans provide only little information after surgery in asymptomatic patients. Considering the declining capacity in ICUs and qualified nursing staff, the routine performance of MR scans within 48-72 hours in patients with gliomas, and the additional costs of CT imaging we have to question the real need of early postoperative routine CT imaging in this group of patients.