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Neuroscience: Outpatient Brain Tumor and Spinal Decompression Surgery Safe

There were no thromboembolic complications

According to a study published recently in Neurosurgery, outpatient craniotomy, biopsy, and spinal decompression are safe and effective.

As advances have been made in neurosurgery, the possibility of outpatient procedures has emerged. Preliminary studies indicate that they are safe, but neurosurgeons have been slow to attempt this new approach. The authors of the current study therefore examined 1,003 outpatient surgery cases of prospectively selected patients undergoing craniotomy for intra-axial tumor, brain biopsy, or spinal decompression at a Toronto hospital between August 1996 and December 2009. They wanted to assess postoperative complications and the rate of successful discharge from the day surgery unit (DSU) as well as patient satisfaction. The authors excluded patients with significant medical comorbidities such as obesity and respiratory compromise, poor neurological status or uncontrolled seizures before the operation, and patients who were already admitted as an inpatient.

Nearly 93 percent of patients who underwent craniotomy were successfully discharged from the DSU; 97 percent of patients who underwent spinal decompression were successfully discharged from the DSU; and 94 percent who underwent brain biopsy were successfully discharged. Only two patients (0.20 percent) chose to be admitted after surgery, meaning more than 99 percent were satisfied with their postoperative state. None of the patients experienced complications because of early discharge. The authors estimated these outpatient surgeries to have saved the hospital almost $3.5 million in expenses. They conclude that they are “safe, successful, and cost-effective.”

Source: Purzner T, Purzner J, Massicotte EM, Bernstein M. 2011. Outpatient brain tumor surgery and spinal decompression: a prospective study of 1003 patients. Neurosurgery 69(1):119-127.