背景:术中神经外科辅助手术可改善切除程度,同时减轻患者发病率。通过这些辅助手段提供神经外科护理是高收入国家的常态,但还没有一项研究强调神经外科肿瘤辅助治疗在非洲的使用。本文旨在提供在非洲使用这些附件的认识,有限采购的原因和问题的可能解决方案。
方法:本范围审查按照PRISMA-ScR指南进行。神经外科肿瘤学的语义衍生物,附件和非洲被应用于医学数据库。在非洲进行的研究,其结果与辅助使用有关,发病率,选择死亡率和生活质量.书籍章节和评论被排除在外。
结果:最终分析中纳入了13项研究,共287例患者(0.5至74岁)。大多数研究是队列观察性的(46.2%),起源于南非(46.2%)。脑膜瘤是最普遍的肿瘤组织学(39.4%),神经导航是最容易使用的手术切除辅助手段(30.8%)。使用附属物,接近一半的患者队列(49.8%)实现了总切除.技术有限,缺乏经验,设备成本和电源不一致是导致缺乏辅助使用的因素。
结论:神经外科辅助手术在神经外科肿瘤学中提供了显著的益处。由于资源有限和经验丰富的专业人员,非洲大部分地区对术中辅助设备的利用有限。以捐赠和教育为重点的双边伙伴关系将促进非洲安全和可持续的附属公司。
Intraoperative neurosurgical adjuncts improve extent of resection whilst mitigating patient morbidity. The delivery of neurosurgical care via these adjuncts is the norm in high-income countries, but there is yet to be a study highlighting the usage of neurosurgical oncology adjuncts in Africa. This paper aims to provide awareness of the use of these adjuncts in Africa, reasons for limited procurement, and possible solutions to the problem.
This scoping review was conducted in accordance with Preferred Reporting Items for Systematic Review and Meta-Analysis Extension for Scoping Reviews guidelines. Semantic derivatives of neurosurgical oncology, adjuncts, and Africa were applied to medical databases. Studies in Africa with outcomes relating to adjunct usage, morbidity, mortality, and quality of life were selected. Book chapters and reviews were excluded.
Thirteen studies with 287 patients (0.5 to 74 years) were included in the final analysis. Most studies were cohort observational (46.2%) and originated from South Africa (46.2%). Meningioma was the most prevalent tumor histology (39.4%), and neuronavigation was the most readily used adjunct for surgical resection (30.8%). Using adjuncts, gross total resection was achieved in close to half the patient cohort (49.8%). Limited technology, lack of experience, cost of equipment, and inconsistency in power supply were noted as factors contributing to lack of adjunct usage.
Neurosurgical adjuncts provide significant benefits in neurosurgical oncology. There is limited utilization of intraoperative adjuncts in most of Africa owing to limited resources and experienced professionals. Bilateral partnerships with a focus on donation and education will foster safe and sustainable adjunct incorporation in Africa.