• Stephanie Anetsberger, Amine Mellal, Marta Garvayo, Manuel Diezi, Marie-Helene Perez, Maja Beck Popovic, Raffaele Renella, Giulia Cossu, Roy Thomas Daniel, Daniele Starnoni, and Mahmoud Messerer.
• Department of Neurosurgery, Department of Neuroscience, Lausanne University Hospital and Lausanne, Lausanne, Switzerland.
• World Neurosurg. 2023 Apr 1; 172: e508e516e508-e516.

ObjectiveCentral nervous system tumors are the most common solid neoplasm in children, 60%-70% occurring in the posterior fossa. Surgery is the mainstay of treatment but surgery in the pediatric population is associated with a high risk of perioperative complications. We aimed at analyzing the perioperative complications after posterior fossa surgery in a pediatric population and identifying the associated risk factors.MethodsRetrospective study of all pediatric patients undergoing surgery for resection of a posterior fossa tumor between 1999 and 2019, at the University Hospital of Lausanne. Data were collected including age, clinical presentation, tumor localization, presence of preoperative hydrocephalus, timing of surgery, surgical approach, surgical team, extent of surgical resection, perisurgical complications, and histopathological diagnosis. Statistical analysis was performed to correlate the data with the risk of complications.ResultsSixty-seven patients were included. Perisurgical complications were identified in 39 patients (58.2%), of which 14 (35.9%) required corrective interventions. The perioperative mortality rate was zero. In the univariate analysis, surgery performed under emergency conditions, transvermian and telovelar approaches were statistically correlated with an increased rate of complications. Extent of resection, hydrocephalus, and Lansky index at presentation were not predictive of perioperative complications. Midline tumor, tumor volume >25 cm3, and surgery performed by a nonspecialized pediatric onconeurosurgeon were found to be independent risk factors in the multivariate analysis.ConclusionsSurgery in the posterior fossa in the pediatric population harbors a high risk of complications. Identifying the variables contributing to these complications is important in order to improve surgical management of these patients.Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.

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