EMBARGOED FOR RELEASECONTACT: 847/378-0517Heather Monroe ([email protected])
Some Neurosurgeons Treat Brain Tumor Craniotomies Effectively as an Outpatient Procedure
CHICAGO (April 8, 2002) -Some neurosurgeons make surgery less traumatic for patients by treating tumor craniotomies effectively as an outpatient procedure. The study, "Outpatient Craniotomy for Brain Tumors: A Pilot Study with 59 Patients," will be presented by Mark Bernstein, MD, FRCSC, on Monday, April 8, from 2:45 to 5:15 p.m., during the 70th Annual Meeting of the American Association of Neurological Surgeons (AANS).
Since 1991 the author of the study has preferred using awake craniotomies as a routine approach for the majority of patients with tumors requiring resection (removal). In late 1996, a pilot study was initiated to assess the feasibility of performing craniotomy for brain tumor resection as an outpatient procedure. Outpatient craniotomy means: 1) craniotomy (surgical opening of the skull), not a burr hole; 2) tumor resection, not only a biopsy; 3) less than a total of 12 hours spent in the hospital including all imaging studies and surgery; and 4) outpatient procedure was planned initially and the patient was not discharged early.
During pre-surgical visits, patients scheduled for awake craniotomy for tumor resection who had quality home support systems were given the chance to participate in the study (on a voluntary basis). The patients then went through a thorough evaluation, and informed consent was obtained for surgery. Patients participating in the study had surgery at 8 a.m., were observed in the recovery room for four hours, and were visited by a home care nurse that evening at 11 p.m. and the next morning at 8 a.m. Patients were then reviewed in the neurosurgeon's office to discuss final steps, plan further treatment or follow-up imaging one week following surgery.
During the 62 month period between December 1996 and February 2002, 307 patients underwent awake craniotomy for tumor resection, and of those patients, 59 (19 percent) were participants of the outpatient craniotomy procedure at an average of approximately one patient per month.
A total of 31 males and 28 females, ranging in age from 18 to 78 years old participated in the study. For 52 patients, it was their first surgery, and for seven it was a repeat craniotomy. A total of 48 patients were operated on with image-guidance provided by a surgical navigation system, and 11 were operated on using an open magnet specially designed for real-time image-guided brain surgery.
Out of 59 participating patients, a total of 53 successfully completed the outpatient craniotomy procedure (90 percent). There were six complications in the 59 "intent-to-treat group" (10 percent). No patients experienced morbidity as a result of same-day discharge or were disadvantaged by entry into the study.
"In addition to being resource-friendly, this procedure may be psychologically less traumatic for patients than the standard craniotomy for brain tumor because it minimizes the magnitude of the procedure and decreases time in the hospital," said Mark Bernstein, MD, an author of the study and AANS member. "Widespread adoption of this treatment option throughout society is unlikely, but select patients are willing, safe, and satisfied with the outpatient procedure."
Founded in 1931 as the Harvey Cushing Society, the American Association of Neurological Surgeons is a scientific and educational association with nearly 5,500 members worldwide. The AANS is dedicated to advancing the specialty of neurological surgery in order to provide the highest quality of neurosurgical care to the public. All active members of the AANS are certified by the American Board of Neurological Surgery. Neurological surgery is the medical specialty concerned with the prevention, diagnosis, treatment and rehabilitation of disorders that affect the entire nervous system including the spinal column, spinal cord, brain and peripheral nerves.
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Media Representatives: If you would like to cover the meeting or interview a neurosurgeon - either on-site or via telephone - please contact the AANS Communications Department at (847) 378-0517 or call the Annual Meeting Press Room beginning Monday, April 8 at (312) 949-3201 (3202).
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