- Background: Resection of brain metastases in the posterior fossa (PF) are either performed in the prone, supine or the semi-setting position. Comparative data is missing.
Methods: A retrospective comparative analysis from January 2018 to December 2020 in two neurosurgical departments was performed. All patients with brain metastases located in the PF were included. Groups A, B and C consisted of patients following resection in the semi-sitting, prone and supine position, respectively. Comparative analysis was conducted with regards of morbidity and mortality.
Results: 60 patients were identified (30 patients from each center). 42% were female. The median age was 67 year (range 36-83 years). Group A, B and C included 30, 11 and 19 patients, respectively. Surgical times were similar between group A (167 min [range 89-329 min]) and B (184 min [range 139-285 min]) but definitely shorter in group C (139 min [range 44-260 min]) (p=0.05). Median anaesthesia times remained similar in the ABackground: Resection of brain metastases in the posterior fossa (PF) are either performed in the prone, supine or the semi-setting position. Comparative data is missing.
Methods: A retrospective comparative analysis from January 2018 to December 2020 in two neurosurgical departments was performed. All patients with brain metastases located in the PF were included. Groups A, B and C consisted of patients following resection in the semi-sitting, prone and supine position, respectively. Comparative analysis was conducted with regards of morbidity and mortality.
Results: 60 patients were identified (30 patients from each center). 42% were female. The median age was 67 year (range 36-83 years). Group A, B and C included 30, 11 and 19 patients, respectively. Surgical times were similar between group A (167 min [range 89-329 min]) and B (184 min [range 139-285 min]) but definitely shorter in group C (139 min [range 44-260 min]) (p=0.05). Median anaesthesia times remained similar in the A [268 min, range 170-465 min] and B group [273 min, range 200-354 min], but were also significantly shorter in the C group [201 min, range 105-363 min] (p=0.001). Interestingly the mean Karnofsky index deteriorated significantly in the A group (p=0.005). Based on complication rates we experienced siginificantly more deaths (4 patients) and severe postoperative complications in group A (p<0.0001). Moreover patients treated in group A (24 days, [range 4-75 days]) had a more prolonged hospital stay compared to the other two groups (group B - 15 days, [range 4-30 days]; group C - 14 days [range 5-29 days]).
Conclusion: The semi-setting position is associated with worse clinical outcome and prolonged hospital stay for patients with brain metastases in the PF.…
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