Ahluwalia Ranbir, Rocque Brandon G, Shannon Chevis N, Blount Jeffrey P
Surgical Outcomes Center for Kids, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA.
Florida State University College of Medicine, 1115 W Call St., Tallahassee, FL, 32304, USA.
Childs Nerv Syst. 2020 Jul;36(7):1347-1355. doi: 10.1007/s00381-020-04671-x. Epub 2020 May 20.
SARS-CoV-2 COVID-19, coronavirus, has created unique challenges for the medical community after national guidelines called for the cancellation of all elective surgery. While there are clear cases of elective surgery (benign cranial cosmetic defect) and emergency surgery (hemorrhage, fracture, trauma, etc.), there is an unchartered middle ground in pediatric neurosurgery. Children, unlike adults, have dynamic anatomy and are still developing neural networks. Delaying seemingly elective surgery can affect a child's already vulnerable health state by further impacting their neurocognitive development, neurologic functioning, and potential long-term health states. The purpose of this paper is to demonstrate that "elective" pediatric neurosurgery should be risk-stratified, and multi-institutional informed guidelines established.
严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）引发的新型冠状病毒肺炎（COVID-19），在国家指南要求取消所有择期手术后，给医学界带来了独特的挑战。虽然存在明确的择期手术（良性颅骨美容缺陷）和急诊手术（出血、骨折、创伤等）案例，但小儿神经外科领域存在一片未知的中间地带。与成人不同，儿童的解剖结构处于动态变化中，神经网络仍在发育。推迟看似择期的手术可能会进一步影响儿童的神经认知发育、神经功能及潜在的长期健康状况，从而影响其本就脆弱的健康状态。本文旨在证明，“择期”小儿神经外科手术应进行风险分层，并制定多机构知情指南。
