Roth Jonathan, Constantini Shlomi
Department of Pediatric Neurosurgery, Dana Children's Hospital, Tel-Aviv Medical Center, Tel-Aviv University, 6 Weizman Street, 64239, Tel Aviv, Israel.
Childs Nerv Syst. 2020 May;36(5):919-924. doi: 10.1007/s00381-020-04562-1. Epub 2020 Mar 6.
Aborting a neurosurgical procedure is a situation in which the surgeon modifies the original surgical plan and decides to stop a procedure without achieving the pre-operative goal. While adhering to predefined goals is important, intra-operative judgment, especially in terms of adjusting the risk/benefit ratio in response to real-time data, may change the balance and lead, in selective scenarios, to aborting of a procedure. The literature regarding aborting a surgical procedure is sparse, with no objective guidelines on when, and how, to make such a decision. Defining "when to abort" is difficult and is influenced by many factors, including unexpected intraoperative findings, the surgeon's surgical experience and perspective, and the patient and family perspective. Aborting a procedure is a decision that must be ultimately determined by the surgical findings and the individual treatment alternatives. The aim of this paper is to discuss the condition of aborting a neurosurgical procedure, using the relatively common endoscopic third ventriculostomy (ETV) as a model procedure prototype.
中止神经外科手术是指外科医生修改原手术计划并决定在未达成术前目标的情况下停止手术。虽然坚持预定目标很重要，但术中判断，尤其是根据实时数据调整风险/收益比时，可能会改变平衡，并在某些特定情况下导致手术中止。关于中止外科手术的文献很少，对于何时以及如何做出这样的决定没有客观的指导原则。确定“何时中止”很困难，并且受到许多因素的影响，包括术中意外发现、外科医生的手术经验和观点以及患者和家属的观点。中止手术是一个最终必须由手术结果和个体治疗方案决定的决策。本文的目的是以内镜下第三脑室造瘘术（ETV）这种相对常见的手术作为模型手术原型，讨论中止神经外科手术的情况。
