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Prone versus sitting position in pediatric low-grade posterior fossa tumors

  • Valentina BaroEmail author
  • Riccardo Lavezzo
  • Elisabetta Marton
  • Pierluigi Longatti
  • Andrea Landi
  • Luca Denaro
  • Domenico d’Avella
Original Article
  • 23 Downloads

Abstract

Purpose

The choice between sitting and prone position to access the infratentorial space in a suboccipital craniotomy is still a matter of debate. The comparisons in terms of complications and outcome of both positions are scarce, and the pediatric population is indeed more infrequent in these in scientific reviews. In this paper, we assess intraoperative and postoperative complications and neurological outcome in pediatric patients undergoing posterior cranial fossa surgery for pilocytic astrocytoma in sitting and prone position respectively.

Methods

We retrospectively analyzed 30 consecutive patients undergoing surgery for cerebellar pilocytic astrocytoma at the two neurosurgical units referring to the University of Padova Medical School from 1999 to 2017. Preoperative, intraoperative, and postoperative data were retrieved from our medical archives.

Results

The statistical analysis did not show any differences between the two groups in terms of preoperative, intraoperative, and postoperative data. The neurological status at last follow-up was similar in both groups of patients.

Conclusions

Our results suggest that both sitting and prone position can be considered safe in suboccipital craniotomies. Further studies are needed to show if there are possible differences between these positions for other frequent pediatric tumors such as medulloblastomas and ependymomas.

Keywords

Surgical positions Complications Outcome Pilocytic astrocytoma Children 

Abbreviations

PA

Pilocytic astrocytoma

PCFT

Posterior fossa cerebral tumor

VAE

Venous air embolism

PICU

Pediatric intensive care unit

PFO

Patent foramen ovale

TEE

Transesophageal echocardiography

PP

Prone position

SP

Sitting position

PPG

Prone position group

SPG

Sitting position group

EVD

External ventricular drainage

CSF

Cerebrospinal fluid

MRC

Medical research council

SD

Standard deviation

Notes

Compliance with ethical standards

Conflict of interest

The authors report no conflict of interest concerning the materials or methods used in this study or the findings disclosed in this paper.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Academic Neurosurgery, Department of NeurosciencesUniversity of Padova Medical SchoolPadovaItaly
  2. 2.Department of Neurosurgery, Treviso HospitalUniversity of Padova Medical SchoolTrevisoItaly

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