Article
Creating a national centre of paediatric neurosurgery in the Slovak Republic – is there a need for a centralised special care in paediatric neurosurgery?
Schaffung eines nationalen Zentrums für Kinderneurochirurgie in der Slowakischen Republik – ist eine zentralisierte Spezialversorgung in der Kinderneurochirurgie erforderlich?
Search Medline for
Authors
-
Robert Chrenko
- Nationalinstitut für Kinderkrankheiten, Kinderneurochirurgie - Neurocentrum, Bratislava, Slowakei
-
Benedikt Trnovec
- Nationalinstitut für Kinderkrankheiten, Kinderneurochirurgie - Neurocentrum, Bratislava, Slowakei
-
Frantisek Horn
- Nationalinstitut für Kinderkrankheiten, Kinderneurochirurgie - Neurocentrum, Bratislava, Slowakei
-
Zuzana Humpolcova
- Nationalinstitut für Kinderkrankheiten, Kinderneurochirurgie - Neurocentrum, Bratislava, Slowakei
-
Miroslava Kohutkova
- Nationalinstitut für Kinderkrankheiten, Kinderneurochirurgie - Neurocentrum, Bratislava, Slowakei
-
Michal Petrik
- Nationalinstitut für Kinderkrankheiten, Kinderneurochirurgie - Neurocentrum, Bratislava, Slowakei
-
Robert Jasenek
- Nationalinstitut für Kinderkrankheiten, Kinderneurochirurgie - Neurocentrum, Bratislava, Slowakei
-
Milan Liska
- Nationalinstitut für Kinderkrankheiten, Kinderneurochirurgie - Neurocentrum, Bratislava, Slowakei
-
Martin Sedliak
- Nationalinstitut für Kinderkrankheiten, Kinderneurochirurgie - Neurocentrum, Bratislava, Slowakei
-
Bruno Rudinsky
- Nationalinstitut für Kinderkrankheiten, Kinderneurochirurgie - Neurocentrum, Bratislava, Slowakei
| Published: | June 4, 2021 |
|---|
Outline
Text
Objective: The high need for a national centre in our country was stated according to insufficient care in paediatric neurosurgery and growing number of patients undergoing their neurosurgical care abroad. A new neurosurgical department with neuropaediatric expertise was established in Bratislava with a catchment area of about 2 million inhabitants for regular procedures and 5.5 million (nationwide) for specialised procedures.
Methods: The facts from the official and medical records are summarized and compared with the historical records and with the reminiscences of participants. We analysed the procedures during the first 18 months after establishing the new departement.
Results: Team consisting of 3 neurosurgeons, 1 paediatric surgeon, 3 neurosurgical residents, 3 part-time neurosurgeons, 1 neurologist (electrophysiologist) and 1 part-time psychologist. There were 551 surgeries during the first 18 months. The spectrum range is wide: tumours (83), vascular (9), developmental disorders and cysts (45), hydrocephalus (166), cranial trauma (23), spinal trauma (16), peripheral nerves (10), functional (39) and minor precedures (160). We established successful and growing interdisciplinary cooperation with paediatric anaesthesiology, neurology, neonatology, surgery, radiology, oncology, ENT, ophtalmology and paediatrics in the National Children´s Hospital.
Conclusion: Despite the rigidity of the traditional neurosurgical service in process of founding of paediatric neurosurgical centre there seem to be significant benefits in the patient care in comparison with the historical records: 1. Introduction of up-to-date standards of the paediatric neurosurgical care, 2.Introduction of novel procedures (endoscopic surgery for craniostenosis, endoscopic surgery for tumours, cysts and hydrocephalus, neuroendoscopic lavage for neonatal hemorrhage, microsurgery for peripheral nerves, paediatric spinal instrumentation, endovascular intervention for pediatric vascular malformations and tumours, novel techniques of the intraoperative neuromonitoring), 3.Up-to-date revitalisation of historicaly performed procedures (tumour and vascular microsurgery, open surgery for developmental disorders, shunting procedures, spasticity and epilepsy), 4.Highly specialized equipment of the neurosurgical OP room, 5.Focused psychological support of the parents, 6.Shortening of the waiting period for surgery, 7.Elimination of the need for the specialized patient care abroad
