Lovo EE, Minervini M, Ahues E, Martínez-Cortez R, Moreira H, Arévalo EB

Language: Spanish
References: 20
Page: 142-146
PDF size: 99.26 Kb.

ABSTRACT

Objective: awake craniotomy (CV) technique has facilitated for many years the extraction of intracerebral lesions near eloquent cortex due to the immediate information that can be obtained via cortico-stimulation. The objective of the present study was to investigate comparative costs at our center between CV and general anesthesia (AG). Method: we analyzed the cases that were operated under CV from November 2007 to October 2012 at the Hospital de Diagnóstico de El Salvador. During this period 63 patients were operated using CV, 45 patients with oncological pathology were chosen that could be compared to 45 patients that were operated by the same team but under AG. Comparative costs were studied and broken down in the direct cost of procedure, hospital stay in regular and intermediate care units. A brief description of the techniques used is provided and clinical results with regards to volumetric resection and neurological complications. Results: the average cost of CV was 6,540 USD (6,300 – 6,900) versus 8,550 USD (8,000 - 9,000) of AG p.0003. Operating room time was 257.49 minutes in CV and 247.51 minutes for AG p.0.63. The average hospitalization time was in CV 2.1 days (1-4) and 2.9 days in AG (2-5) p.0.004. Three (6.6%) patients of CV needed Intermediate Care (UCIM), in AG 6 (13.3%) patients needed UCIM p.0.04. The proportion of lesions next to or in eloquent cortex was CV (36) versus AG (15) 2.4:1 p= 0.0031. Volumetric resection according MRI was 92% (40-100) in CV vs 95% (62-100) in AG, p.0.5. Conclusions: awake craniotomy showed to be less expensive than AG and has less hospital stay. Both series were not comparable with regards to tumor resection in eloquent or near eloquent cortex and complications due to the fact that most of the complex cases were operated under CV.

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