Baro Valentina, Lavezzo Riccardo, Marton Elisabetta, Longatti Pierluigi, Landi Andrea, Denaro Luca, d'Avella Domenico
Academic Neurosurgery, Department of Neurosciences, University of Padova Medical School, via Giustiniani 5, 35100, Padova, Italy.
Department of Neurosurgery, Treviso Hospital, University of Padova Medical School, Via Piazzale 1, 31100, Treviso, Padova, Italy.
Childs Nerv Syst. 2019 Mar;35(3):421-428. doi: 10.1007/s00381-018-04031-w. Epub 2019 Jan 4.
The choice between sitting and prone position to access the infratentorial space in a suboccipital craniotomy is still a matter of debate. The comparisons in terms of complications and outcome of both positions are scarce, and the pediatric population is indeed more infrequent in these in scientific reviews. In this paper, we assess intraoperative and postoperative complications and neurological outcome in pediatric patients undergoing posterior cranial fossa surgery for pilocytic astrocytoma in sitting and prone position respectively.
We retrospectively analyzed 30 consecutive patients undergoing surgery for cerebellar pilocytic astrocytoma at the two neurosurgical units referring to the University of Padova Medical School from 1999 to 2017. Preoperative, intraoperative, and postoperative data were retrieved from our medical archives.
The statistical analysis did not show any differences between the two groups in terms of preoperative, intraoperative, and postoperative data. The neurological status at last follow-up was similar in both groups of patients.
Our results suggest that both sitting and prone position can be considered safe in suboccipital craniotomies. Further studies are needed to show if there are possible differences between these positions for other frequent pediatric tumors such as medulloblastomas and ependymomas.
在枕下开颅手术中，选择坐位还是俯卧位进入幕下间隙仍存在争议。关于这两种体位的并发症和手术结果的比较较少，而且在科学综述中儿科患者的相关情况确实更为罕见。在本文中，我们分别评估了接受坐位和俯卧位手术治疗毛细胞型星形细胞瘤的儿科患者的术中及术后并发症和神经功能转归。
我们回顾性分析了1999年至2017年在帕多瓦大学医学院所属的两个神经外科科室连续接受小脑毛细胞型星形细胞瘤手术的30例患者。术前、术中和术后数据均从我们的医学档案中获取。
统计学分析显示，两组在术前、术中和术后数据方面均无差异。两组患者最后一次随访时的神经状态相似。
我们的结果表明，在枕下开颅手术中，坐位和俯卧位均可视为安全的。需要进一步研究以明确对于其他常见的儿科肿瘤，如髓母细胞瘤和室管膜瘤，这两种体位之间是否可能存在差异。
