Zhang Yu, Ji Peigang, Wang Shoujie, Qin Huaizhou, Cai Qing
Department of Neurosurgery, Tangdu Hospital, Air Force Military Medical University, Xi'an, China.
Front Oncol. 2022 May 6;12:898873. doi: 10.3389/fonc.2022.898873. eCollection 2022.
To evaluate the rate of, reasons for, and predictors of unplanned reoperation after craniotomy for glioma in a single-institution consecutive series.
Patients who underwent glioma resection at our hospital from 2015 to 2021 were included (n=1563). Multivariate logistic regression was used to examine the predictors of early unplanned cranial reoperation. The predictors that were screened included patient age, sex, tumor properties, blood loss, blood pressure and antiplatelets drugs usage.
A total of 3.6% (56/1563) of the patients underwent an early unplanned reoperation after craniotomy for glioma. The reasons for early unplanned reoperation were brain edema (48.2%), cerebral infarction (33.9%) and hemorrhage (17.9%). The predictors of early unplanned reoperation were WHO grade III-IV, peritumoral edema ≥1 cm, subtotal resection, arterial/venous involvement and elevation in blood pressure ≥50 mmHg.
Glioma properties and blood pressure management are decisive predictors of early unplanned reoperation for glioma resection. The authors provide a nuanced discussion regarding early unplanned reoperations and perioperative process improvement as a quality indicator for glioma patient populations.
在一个单机构连续系列研究中，评估胶质瘤开颅术后计划外再次手术的发生率、原因及预测因素。
纳入2015年至2021年在我院接受胶质瘤切除术的患者（n = 1563）。采用多因素逻辑回归分析早期计划外颅脑再次手术的预测因素。筛选的预测因素包括患者年龄、性别、肿瘤性质、失血量、血压及抗血小板药物使用情况。
共有3.6%（56/1563）的患者在胶质瘤开颅术后接受了早期计划外再次手术。早期计划外再次手术的原因包括脑水肿（48.2%）、脑梗死（33.9%）和出血（17.9%）。早期计划外再次手术的预测因素为世界卫生组织（WHO）III-IV级、瘤周水肿≥1 cm、次全切除、动静脉受累及血压升高≥50 mmHg。
胶质瘤性质和血压管理是胶质瘤切除术后早期计划外再次手术的决定性预测因素。作者针对早期计划外再次手术及围手术期流程改进作为胶质瘤患者群体质量指标进行了细致入微的讨论。
