Can a "novice" do aneurysm surgery? Surgical outcomes in a low-volume, non-subspecialised neurosurgical unit.
The objective of this paper is to review the results of a junior general neurosurgeon performing aneurysm surgery and compare these to the remainder of his low-volume unit. Prospectively collected data was analysed for 114 aneurysms clipped in 99 patients between July 2001 and May 2005. Overall there was a 0.9% mortality rate and 10.8% complication rate. The favourable outcome rate for the unit was 100% for unruptured aneurysms, 90.4% for grades 1-3 patients and 30% for poor grade patients (grades 4 and 5). The novice neurosurgeon had no mortality and a favourable outcome rate of 94.7% for grades 1-3 patients and 50% for poor grade patients. Acceptable results can be obtained with cerebral aneurysm surgery in a low-volume centre by Australian-trained, non-subspecialty neurosurgeons.
Goldschlager
T
T
Department of Neurosurgery, Level 7, Ned Hanlon Building, Royal Brisbane Hospital, Brisbane, Queensland 4029, Australia.
Selvanathan
S
S
Walker
D G
DG
D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000401:mortality; D005257:Fellowships and Scholarships; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D006849:Hydrocephalus / Q000401:mortality; D002532:Intracranial Aneurysm / Q000401:mortality* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009493:Neurosurgery / Q000193:education / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011446:Prospective Studies; D013345:Subarachnoid Hemorrhage / Q000401:mortality / Q000601:surgery; D013530:Surgical Wound Infection / Q000401:mortality; D020301:Vasospasm, Intracranial / Q000401:mortality