Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Acta Neurochir (Wien). 2019 Feb;161(2):333-341. doi: 10.1007/s00701-019-03799-3. Epub 2019 Jan 24.
Surgery is the main treatment modality for intracranial meningiomas, but data on short-term surgical outcome are limited. The aim of this Swedish nationwide registry-based study was to benchmark the 30-day complication rate in a cohort of meningioma patients using data from the Swedish brain tumor registry (SBTR). Furthermore, we investigated outcomes for asymptomatic patients.
Data were collected from the SBTR for all adults with histopathologically verified intracranial meningioma between 2009 and 2015. Patient symptoms, tumor characteristics, and complications within 30 days postoperatively were analyzed.
In total, 2324 patients, with a mean age of 58.7 years (SD 13.5), underwent surgery for intracranial meningioma and 14.1% of the patients were asymptomatic before the intervention. The most common symptom prior to treatment was focal deficit, which occurred in 1450 patients (62.4%). Moreover, within 30 days after surgery, 344 patients (14.8%) developed new neurological deficits and new-onset seizures occurred in 105 patients (4.5%), while 8.3% of asymptomatic patients developed neurological deficit and 3.7% new-onset seizures. Due to complications, reoperations were performed in 120 patients (5.2%). The postoperative 30-day mortality in the whole cohort was 1.5%.
This study benchmarks the 30-day complication rate after meningioma surgery and provides outcome data in the highly relevant group of asymptomatic patients using data from the Swedish brain tumor registry. Since surgical decision-making is a careful consideration of short-term risk versus long-term benefit, this information may be useful for both caregivers and patients.
手术是颅内脑膜瘤的主要治疗方式，但关于短期手术结果的数据有限。本项基于瑞典全国登记处的研究旨在使用瑞典脑肿瘤登记处（SBTR）的数据，为脑膜瘤患者的 30 天并发症发生率设定基准。此外，我们还调查了无症状患者的结局。
从 SBTR 收集了 2009 年至 2015 年间所有经组织病理学证实的颅内脑膜瘤成人患者的数据。分析了患者症状、肿瘤特征和术后 30 天内的并发症。
共 2324 例患者，平均年龄为 58.7 岁（标准差 13.5），接受了颅内脑膜瘤手术，其中 14.1%的患者在干预前无症状。治疗前最常见的症状是局灶性缺损，共 1450 例患者（62.4%）。此外，术后 30 天内，344 例患者（14.8%）出现新的神经功能缺损，105 例患者（4.5%）出现新发癫痫，而无症状患者中有 8.3%出现神经功能缺损，3.7%出现新发癫痫。由于并发症，120 例患者（5.2%）需要再次手术。整个队列的术后 30 天死亡率为 1.5%。
本研究为脑膜瘤手术后 30 天的并发症发生率设定了基准，并使用瑞典脑肿瘤登记处的数据为无症状患者这一高度相关的群体提供了结局数据。由于手术决策是对短期风险与长期获益的仔细权衡，因此这些信息可能对医护人员和患者都有用。
