Increased Operative Time for Benign Cranial Nerve Tumor Resection Correlates with Increased Morbidity Postoperatively

Abstract

Objectives Operative time, previously identified as a risk factor for postoperative morbidity, is examined in patients undergoing benign cranial nerve tumor resection.

Design/Setting/Participants This retrospective cohort analysis included patients enrolled in the ACS-NSQIP registry from 2007 through 2013 with a diagnosis of a benign cranial nerve neoplasm.

Main Outcome Measures Primary outcomes included postoperative morbidity and mortality. Readmission and reoperation served as secondary outcomes.

Results A total of 565 patients were identified. Mean (median) operative time was 398 (370) minutes. The 30-day complication, readmission, and return to the operating room rates were 9.9%, 9.9%, and 7.3%, respectively, on unadjusted analyses. CSF leak requiring reoperation or readmission occurred at a rate of 3.1%. On multivariable regression analysis, operations greater than 413 minutes were associated with an increased odds of overall complication (OR 4.26, 95% CI 2.08–8.72), return to the operating room (OR 2.65, 95% CI 1.23–5.67), and increased length of stay(1.6 days, 95% CI 0.94–2.23 days). Each additional minute of operative time was associated with an increased odds of overall complication (OR 1.004, 95% CI 1.002–1.006) and increased length of stay (0.006 days, 95% CI 0.004–0.008).

Conclusion Increased operative time in patients undergoing surgical resection of a benign cranial nerve neoplasm was associated with an increased rate of complications.

Keywords

acoustic neuroma - vestibular schwannoma - skull base - operative time - complications - national surgical quality improvement program

• References

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