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Raffa G, Spiriev T, Zoia C, Aldea CC, Bartek Jr J, Bauer M, Ben-Shalom N, Belo D, Drosos E, Freyschlag CF, Kaprovoy S, Lepic M, Lippa L, Rabiei K, Schwake M, Stengel FC, Stienen MN, Gandía-González ML. The use of advanced technology for preoperative planning in cranial surgery - A survey by the EANS Young Neurosurgeons Committee. Brain Spine 2023; 3:102665. [PMID: 38021023 PMCID: PMC10668051 DOI: 10.1016/j.bas.2023.102665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 08/16/2023] [Accepted: 08/25/2023] [Indexed: 12/01/2023]
Abstract
Introduction Technological advancements provided several preoperative tools allowing for precise preoperative planning in cranial neurosurgery, aiming to increase the efficacy and safety of surgery. However, little data are available regarding if and how young neurosurgeons are trained in using such technologies, how often they use them in clinical practice, and how valuable they consider these technologies. Research question How frequently these technologies are used during training and clinical practice as well as to how their perceived value can be qualitatively assessed. Materials and methods The Young Neurosurgeons' Committee (YNC) of the European Association of Neurosurgical Societies (EANS) distributed a 14-items survey among young neurosurgeons between June 1st and August 31st, 2022. Results A total of 441 responses were collected. Most responders (42.34%) received "formal" training during their residency. Planning techniques were used mainly in neuro-oncology (90.86%), and 3D visualization of patients' DICOM dataset using open-source software was the most frequently used (>20 times/month, 20.34% of responders). Software for 3D visualization of patients' DICOM dataset was the most valuable technology, especially for planning surgical approach (42.03%). Conversely, simulation based on augmented/mixed/virtual reality was considered the less valuable tool, being rated below sufficiency by 39.7% of responders. Discussion and conclusion Training for using preoperative planning technologies in cranial neurosurgery is provided by neurosurgical residency programs. Software for 3D visualization of DICOM datasets is the most valuable and used tool, especially in neuro-oncology. Interestingly, simulation tools based on augmented/virtual/mixed reality are considered less valuable and, therefore, less used than other technologies.
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Affiliation(s)
- Giovanni Raffa
- Division of Neurosurgery, BIOMORF Department, University of Messina, Messina, Italy
| | - Toma Spiriev
- Department of Neurosurgery, Acibadem CityClinic Tokuda Hospital Sofia, Bulgaria
| | - Cesare Zoia
- Neurosurgery Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Cristina C. Aldea
- Department of Neurosurgery, Cluj County Emergency Hospital, University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Romania
| | - Jiri Bartek Jr
- Department of Clinical Neuroscience, Karolinska Institutet and Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden
- Department of Neurosurgery, Rigshospitalet, Copenhagen, Denmark
| | - Marlies Bauer
- Department of Neurosurgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Netanel Ben-Shalom
- Department of Neurosurgery, Rabin Medical Center, Belinson Campus, Petah Tikva, Israel
| | - Diogo Belo
- Neurosurgery Department, Centro Hospitalar Lisboa Norte (CHLN), Lisbon, Portugal
| | | | | | - Stanislav Kaprovoy
- Burdenko Neurosurgical Center, Department of Spinal and Peripheral Nerve Surgery, Department of International Affairs, Moscow, Russia
| | - Milan Lepic
- Clinic for Neurosurgery, Military Medical Academy, Belgrade, Serbia
| | - Laura Lippa
- Dept of Neurosurgery, ASST Ospedale Niguarda, Milano, Italy
| | - Katrin Rabiei
- Institution of Neuroscience & Physiology, Sahlgrenska Academy, Gothenberg, Sweden
- Art Clinic Hospitals, Gothenburg, Sweden
| | - Michael Schwake
- Department of Neurosurgery, University Hospital Muenster, Germany
| | - Felix C. Stengel
- Department of Neurosurgery and Spine Center of Eastern Switzerland, Cantonal Hospital St.Gallen, St.Gallen, Switzerland
| | - Martin N. Stienen
- Department of Neurosurgery and Spine Center of Eastern Switzerland, Cantonal Hospital St.Gallen, St.Gallen, Switzerland
| | - Maria L. Gandía-González
- Department of Neurosurgery, Hospital Universitario La Paz, Idipaz, Madrid, Spain
- University Autonomous of Madrid, Spain
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Ma J, Alattar A, Dhawan S, Jakola A, Bartek Jr J, Chen C. SURG-14. COMPARABLE SURVIVAL OUTCOMES BETWEEN THE ELDERLY AND THEIR YOUNGER COUNTERPARTS AFTER RESECTION OF BENIGN MENINGIOMAS. Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab196.783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
OBJECTIVE
Using the Surveillance, Epidemiology and End Results (SEER) database, we characterized the patterns of surgical recommendations and outcomes after benign meningioma resection in the elderly population.
METHODS
27,839 adult meningioma patients were identified in SEER between 1973- 2015 and 6,967 patients were identified between 2016-18. Patients were stratified into four age groups:18-39, 40-59, 60-79, and > 80 years old. The likelihood for recommendation to proceed with resection, extent of resection, and survival outcome were determined using logistic regression models.
RESULTS
In a multi-variate model that accounted for gender, race, marital status, tumor size, and tumor location, the likelihood of recommendation to proceed with benign meningiomas resection decreased with advancing age. Relative to patients age 40-59, the likelihood of recommendation for surgery were 1.130 (95%CI=0.925-1.380, P=0.230), 0.593 (95%CI=0.531-0.662, P< 0.001), and 0.173 (95%CI=0.146-0.205, P< 0.001) for patients age 18-39, 60-79, and >= 80, respectively. A similar trend in the likelihood of gross total resection (GTR) was observed. Relative to patients age 40-59, the likelihood of gross total resection were 1.009 (95%CI=0.913-1.114, P=0.867), 0.903 (95%CI=0.849-0.961, P=0.001), and 0.580 (95%CI=0.512-0.657, P< 0.001) for patients age 18-39, 60-79, and >= 80, respectively. However, survival after meningioma resection did not vary significantly as a function of patient age. Relative to patients age 40-59, the hazard of death after GTR of meningioma resection were 1.324 (95%CI=0.795-2/203, P=0.280), 0.813 (95%CI=0.639-1.035, P=0.092), and 0.913 (95%CI=0.618-1.350, P=0.649) for patients age 60-79, and >= 80, respectively. These results were validated using SEER data from 2016-2018.
CONCLUSION
This analysis provide evidence that surgeons exert caution in surgical resection of benign meningioma in the elderly, with decreased likelihood for recommending surgery in this population. In patients selected for and underwent gross resection, survival outcome in the elderly was comparable to their younger counterparts, suggesting safety of procedure in appropriately selected elderly.
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Affiliation(s)
- Jun Ma
- University of Minnesota, Minneapolis, MN, USA
| | - Ali Alattar
- University of Pittsburgh, Pittsburgh, PA, USA
| | | | | | | | - Clark Chen
- University of Minnesota, Minneapolis, MN, USA
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