World Neurosurg
-
The role of laboratory dissection training in neurosurgical residency: results of a national survey.
Work hour restrictions and current quality, financial, and legal concerns have reduced resident operative volume and autonomy. Although laboratory (cadaveric or animal) dissection has a rich history in neurosurgery, its current role in resident training is unclear. Recent literature suggests educators have looked to simulation to accelerate the learning curve of acquiring neurosurgical technical skills. The purpose of this study was to determine the prevalence, characteristics, and extent of laboratory dissection in neurosurgical residency programs in the United States. ⋯ In neurosurgical resident education, laboratory dissection is widely used; however, significant variation exists. Nonetheless, program directors believe laboratory dissection plays an integral role in neurosurgical training and is currently associated with greater educational benefit than simulation.
-
To investigate the clinical and pathologic characteristics of primary intradural retroclival chordoma and improve the understanding of this rare disease. ⋯ Our study suggests that a positive staining for brachyury, galectin-3, and Ki-67 would be helpful for differential diagnosis, discriminating intradural retroclival chordoma from ecchordosis physaliphora and chordoid meningioma. Our study also shows that within intradural retroclival chordoma, there are significant prognostic differences. Tumors with an abundant blood supply, flake-like cellular arrangement, and a Ki-67 labeling index greater than 5% belong to a rapid-growth type and are prone to short-term recurrence and poorer prognosis.
-
To analyze the clip repositioning rate and the correlation between indocyanine green (ICG) videoangiography and conventional postoperative digital subtraction angiography for completeness of aneurysm occlusion and parent and branching vessel compromise. ⋯ ICG videoangiography is a very useful modality for intraoperative assessment of the adequacy of aneurysmal obliteration and patency of parent and perforating vessels. However, ICG videoangiography is not absolutely reliable as a stand-alone method during clipping of ophthalmic artery aneurysms and can be complemented with intraoperative digital subtraction angiography. ICG videoangiography can be used either as an alternative or as a complementary technique to intraoperative digital subtraction angiography during aneurysm surgery.