Markus Lenski1,2, Johann Hofereiter3,4, Nicole Terpolilli3,4, Torleif Sandner5,4, Stefan Zausinger3,4, Jörg-Christian Tonn3,4, Friedrich-Wilhelm Kreth3,4, Christian Schichor3,4. 1. Neurochirurgische Klinik und Poliklinik, Department of Neurosurgery, Klinikum der Universität München, Campus Großhadern, Marchioninistraße 15, 81377, Munich, Germany. markus.lenski@med.uni-muenchen.de. 2. German Cancer Consortium, Partner Site Munich, German Cancer Research Center, Heidelberg, Germany. markus.lenski@med.uni-muenchen.de. 3. Neurochirurgische Klinik und Poliklinik, Department of Neurosurgery, Klinikum der Universität München, Campus Großhadern, Marchioninistraße 15, 81377, Munich, Germany. 4. German Cancer Consortium, Partner Site Munich, German Cancer Research Center, Heidelberg, Germany. 5. Department of Neuroradiology, Klinikum der Universität München, Campus Großhadern, Marchioninistraße 15, 81377, Munich, Germany.
Abstract
PURPOSE: Currently, intraoperative computed tomography (iCT) is a scarcely used technique in neurosurgery. It remains unclear whether this phenomenon is explained by unfavorable iCT-related workflows and/or a limited number of indications. We here analyzed workflows of an installed dual-room iCT (DR-iCT) as compared to surgical procedures lacking iCT. We compared infection rates, utilizations rates, and the spectrum of indications of DR-iCT with that of a previously used single-room iCT. METHODS: The study refers to a consecutive series of patients undergoing either single-room iCT (January 2014-August 2014) or DR-iCT (September 2014-July 2016). A further group undergoing surgery without iCT in the interconnected operating rooms represents the reference group. Workflow measurements and infection rates were calculated. Indications for iCT and utilization rates were compared for each of the devices. CT image quality was rated. RESULTS: Application of DR-iCT led to a broader use of this technique as compared to the single-room device, which concerned in particular stereotactic neurosurgery. Accordingly, iCT utilization rates significantly increased (up to 50.8 ± 4.6 surgeries per month, p < 0.001). Workflow was slightly prolonged in case of DR-iCT imaging; the difference, however, was not statistically significant. Infections rates were low (range 0.0-0.17 infections per month) and not influenced by the utilization rate. Image quality of the DR-iCT was classified as very good in 34/43 evaluated microsurgical patients. CONCLUSIONS: The use of DR-iCT enhances utilization rates with a broader field of indications for intraoperative imaging. Workflow measurements are not significantly prolonged. The technology is safe, and the imaging quality of modern devices can be expected to be good.
PURPOSE: Currently, intraoperative computed tomography (iCT) is a scarcely used technique in neurosurgery. It remains unclear whether this phenomenon is explained by unfavorable iCT-related workflows and/or a limited number of indications. We here analyzed workflows of an installed dual-room iCT (DR-iCT) as compared to surgical procedures lacking iCT. We compared infection rates, utilizations rates, and the spectrum of indications of DR-iCT with that of a previously used single-room iCT. METHODS: The study refers to a consecutive series of patients undergoing either single-room iCT (January 2014-August 2014) or DR-iCT (September 2014-July 2016). A further group undergoing surgery without iCT in the interconnected operating rooms represents the reference group. Workflow measurements and infection rates were calculated. Indications for iCT and utilization rates were compared for each of the devices. CT image quality was rated. RESULTS: Application of DR-iCT led to a broader use of this technique as compared to the single-room device, which concerned in particular stereotactic neurosurgery. Accordingly, iCT utilization rates significantly increased (up to 50.8 ± 4.6 surgeries per month, p < 0.001). Workflow was slightly prolonged in case of DR-iCT imaging; the difference, however, was not statistically significant. Infections rates were low (range 0.0-0.17 infections per month) and not influenced by the utilization rate. Image quality of the DR-iCT was classified as very good in 34/43 evaluated microsurgical patients. CONCLUSIONS: The use of DR-iCT enhances utilization rates with a broader field of indications for intraoperative imaging. Workflow measurements are not significantly prolonged. The technology is safe, and the imaging quality of modern devices can be expected to be good.
Authors: Jun Thorsteinsdottir; Torleif Sandner; Annamaria Biczok; Robert Forbrig; Sebastian Siller; Patricia Bernasconi; Andrea Szelényi; Thomas Liebig; Jörg-Christian Tonn; Christian Schichor Journal: Acta Neurochir (Wien) Date: 2021-10-13 Impact factor: 2.216
Authors: Maximilian Kippnich; Maximilian Duempert; Nora Schorscher; Martin C Jordan; Andreas S Kunz; Patrick Meybohm; Thomas Wurmb Journal: Sci Rep Date: 2022-09-27 Impact factor: 4.996