History and current state of pediatric neurosurgery at Beijing Tiantan Hospital Neurosurgery Center
Beijing Tiantan Hospital Neurosurgery Center (BTHNC) is the most renowned and authorized institute for neurosurgical practice in China. In the early 1980s, 30 years following commitment and diligence in the practice, Dr. Chungcheng Wang, one of a key pioneering figures and co-founders of neurosurgical practice in entire China, founded Beijing Tiantan Hospital for development of neurosurgery. Since then, BTHNC has become the first largest neurosurgical practicing and research institute in the nation [1, 2].
The subdivision of pediatric neurosurgery was also initiated and co-founded by Dr. Wang in Beijing. It was the first unit for children and adolescents that has now become the largest neurosurgical center for treatment and management of all forms of pediatric neurological disorders in the entire nation. At present, this subdivision has a capacity for 40 in-patient beds with over 1000 neurosurgical operations performed with favorable outcomes annually. As a highly reputable tertiary training hospital, the department substantially ranks as the prime frontier in standards of quality and care delivery in the field of the pediatric neurosurgery all over China. It has significantly contributed to the standards and evolution of pediatric neurosurgery practice in China.
Inception and history of Beijing Tiantan Hospital Neurosurgery Center
In 1982, owing to the demand for healthcare delivery and a full-range neurosurgical services, Beijing Tiantan Hospital (Fig.2a), a non-profit public hospital, was founded. In 2004, the name BTHNC was formulated and considered as one of the principle neurosurgical centers and premier specialty institution in China.
History of pediatric unit of BTHNC
Four neurosurgical specialized subdivisions were initially established under Dr. Wang’s leadership in 1960, including brain tumor, pediatrics, trauma, and spine, which were managed by four attending physician-surgeons at the time. Dr. Guangming Bai (Fig.1b) began the first pediatric neurosurgical service in China under the instruction of Dr. Wang.
In 1995, Dr. Zhenyu Ma (Fig.3b) was appointed the chief of the division of pediatric neurosurgery. He has acquired enormous experience and insight into the management of common encountered pediatric brain tumors, including the lesions located in and around the third ventricle, optic pathway glioma, and large deep-seated lesions. His area of expertise in the practice field is often acknowledged as the first in China. In particular, he performed the first microsurgical resection of pineal region tumor with transcallosal-transseptal interforniceal approach in 1997 and has so far performed over 500 cases in a single-center [15, 16, 17]. With higher gross total resection (GTR) rate, low morbidity, and with almost zero mortality, this approach has been popularized by many neurosurgeons and introduced at international conference meetings. Additionally, he also firstly placed forward the practice of the concept of staged craniotomy with different approaches to manage pediatric large deep-seated brain tumors . It has been beneficial to children with optic pathway gliomas by partially removing part of the lesions followed by adjunct radiotherapy [19, 20].
After Dr. Ma’s retirement, Dr. Yuqi Zhang (2009–2012) (Fig.3c) and Ge Jia (2012–2014) (Fig.3d) subsequently headed the division. To further support advancement in the practice [21, 22, 23], they co-founded pediatric committee of Chinese Congress of Neurological Surgeons (CCNS), which is affiliated to Chinese Medical Doctor Association (CMDA). The pediatric committee of CCNS organizes annual academic meetings and serves the domestic pediatric neurosurgical community.
The present program
Since 2014, Dr. Chunde Li (Fig. 3e) took the chief positions in pediatric neurosurgery and as the chair of the pediatric committee of CCNS. He focused more on the quality and efficiency of clinical practice [24, 25, 26, 27, 28, 29, 30, 31]. Additionally, he focused on the clinical research centered around molecular pathology-based target therapy, the application of neuroendoscopy, and multi-modality image-guided neurosurgery. Not only was the operative management of pediatric brain tumors significantly improved, but also congenital central nervous system disorders in infants, including procedures to treat and manage craniosynostosis , and spinal cord malformation have remained the emerging practical focus in this division.
With the full support from powerful BTHNC, Tiantan’s pediatric neurosurgical subdivision has always played the leading role in China. Currently, this subdivision has 40 beds, 8 full-time neurosurgeons, and 2 mentors overseeing pediatric neurosurgical clinical practice and research. Children referred from all over the country benefit from the quality of care and treatment exceptionally provided by the neurosurgeons of the department. Over the past 5 years, there has been an increase in the number of admissions and improvement in the quality of care with significant decrease in mortality rate.
The pediatric brain tumor program has been focusing on the following areas: risk stratification of childhood medulloblastoma in molecular classification , protection for pituitary stalk in craniopharyngioma surgery, multi-modality therapy for optic pathway gliomas  and germ cell tumors [17, 23], progress of basic research for craniopharyngioma , ependymoma, and hypothalamic hamartoma [24, 27, 28]. In addition, numerous publications in peer-reviewed journals have also been published [34, 35, 36, 37, 38]. In 2016, BTHNC became one of the fifteen primary member institutions of the Children’s Brain Tumor Tissue Consortium (CBTTC), which is a collaborative, multi-institutional research program dedicated to the study and treatment of childhood brain tumors.
Pediatric neurosurgery is encountered as a challenging specialty for every neurosurgeon. Beijing Tiantan Hospital is an affiliated hospital and the most important neurosurgical training center for pediatric neurosurgery in China . Annually, national training programs are held in this unit for pediatric neurosurgeons all over China. Owing to the rich clinic resources and high-quality training programs, only several spots become available to eligible candidates to obtain rotational opportunities in its highly competitive residency training program annually. Residents get to rotate through all neurosurgical subspecialties including pediatric unit and get to complete their residency training after completing the structured surgical clinical program requirement. Additionally, this institution attracts the most competent candidates from all over country for clinical fellowship training program annually. Majority of these trainees aim for further development of pediatric neurosurgery in China. Since 1990s, pediatric neurosurgery has dramatically developed mostly in major cities in China, including Shanghai, Nanjing, Guangzhou, and gradually around in China.
It has also been open to welcome international visitors. There is an increasing demand in academic exchange and cooperation between BTHNC and international community, including International Society for Pediatric Neurosurgery (ISPN), a platform where numerous pediatric neurosurgeons interact.
The authors would like to thank Ms. Dan Wang for providing most of photographs in this article.
Compliance with ethical standards
Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
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