Day-case neurosurgery for brain tumours: the early United Kingdom experience.
Day-case biopsy and craniotomy for brain tumours have been reported as safe and feasible options for selected patients. The incidence and timing of complications after such procedures has also been characterized in recent publications. However, more widespread adoption of day-case cranial neurosurgery has not taken place. We report the first UK series of day-case surgery for intra-axial tumours, consisting of 30 image-guided biopsies and 11 craniotomies, taking place over 1 year from October 2006. Patients were studied prospectively and 27/30 biopsy and 9/11 craniotomy patients were discharged 6 h postoperatively. One biopsy case was admitted due to increased headache postoperatively, but with a normal CT and one craniotomy case had transient worsening of lower limb paresis requiring overnight admission. The three other overnight admissions were for patient preference. One biopsy patient was readmitted 30 h postoperatively with a seizure and discharged the following day. No patients suffered an adverse outcome. The results are presented together with the Toronto series of 284 cases over 11 years, also with no patients suffering an adverse outcome because of planned early discharge. These results suggest that day-case surgery for brain tumours is a safe and feasible option for patients in the UK.
Department of Neurosurgery, Wessex Neurological Centre, Tremona Road, Southampton, UK. grundypl@gmail.com
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Grundy
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Weidmann
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Bernstein
D000556:Ambulatory Surgical Procedures / Q000379:methods*; D001706:Biopsy / Q000379:methods; D001932:Brain Neoplasms / Q000601:surgery*; D003399:Craniotomy / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D019635:Neurosurgical Procedures / Q000379:methods*; D011182:Postoperative Care; D011446:Prospective Studies; D013238:Stereotaxic Techniques; D025321:Surgery, Computer-Assisted / Q000379:methods; D006113:United Kingdom