The morbidity of out-of-hours surgery for Cauda Equina Syndrome.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2024-10-01 Epub Date: 2022-01-01 DOI:10.1080/02688697.2021.2019193

Aditaya Kumar, Phil Copley, Aimun Jamjoom, Khaled Badran, Christopher Barrett

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Abstract

Background: There is no literature specifically addressing the morbidity of out of hours surgery for Cauda Equina Syndrome (CES). Our paper rectifies this omission. This will assist the surgeon with real-time decision making with regards to timing of intervention in this rare but potentially disabling disease.

Methods: A retrospective case series analysis. Individual cases were identified using local electronic theatre management systems in the four neurosurgical centres in Scotland in 2017. "Out of hours" surgery was defined as starting outside the times 0900-1700 Monday to Friday.

Results: 86 patients underwent out of hours surgery for CES in Scotland in 2017. One patient sustained a nerve root injury without new deficit, giving an overall risk of 1.2%. Four patients had the intra-operative complication of CSF leak, giving an overall risk of 4.7%. Five patients underwent early revision surgery, equivalent to a re-operation risk of 5.8%.

Conclusions: The morbidity of out of hours surgery for CES is comparable to that of elective microdiscectomy. Operating out of hours for CES does not appear to have an increased risk of complications. Since increased surgical risk is not borne out by our study, this should not be used as a justification to delay operative treatment.

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马尾综合征非工作时间手术的发病率。

背景：目前还没有文献专门论述马尾综合征 (CES) 非工作时间手术的发病率。我们的论文纠正了这一遗漏。这将有助于外科医生对这种罕见但可能致残的疾病进行干预的时机做出实时决策：方法：回顾性病例系列分析。2017年，苏格兰的四个神经外科中心通过当地的电子手术室管理系统确定了单个病例。"非工作时间 "手术定义为周一至周五9:00-17:00以外的时间开始：2017年，苏格兰有86名患者接受了CES的非工作时间手术。一名患者发生神经根损伤，但未出现新的缺损，总体风险为 1.2%。四名患者出现 CSF 渗漏的术中并发症，总体风险为 4.7%。五名患者接受了早期翻修手术，再次手术风险为 5.8%：结论：CES非手术治疗的发病率与择期微椎间孔切除术相当。CES非手术治疗似乎不会增加并发症风险。由于我们的研究并未证实手术风险会增加，因此不应以此为由推迟手术治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.