Introduction: Resection of tumours in the posterior fossa poses a number of challenges. The patients often have significant comorbidity such as metastatic cancer, and can often present emergently with either local pressure symptoms or hydrocephalus. We aimed to determine the mortality associated with surgery, as well as the frequency and manner of associated interventions such as ventricular drainage or haematoma/abscess evacuation that may be required in this population.
Methods: Retrospective chart review of all patients undergoing resection of a tumour from the posterior fossa at our institution between 2006 and 2015
Results: 443 patients underwent posterior fossa tumour resection. 126 patients required a total of 251 further operative interventions during the period reviewed, most commonly for diversion of CSF (183 CSF access/diversion procedure). Five post operative haematomas were evacuated and two abscesses. 19 patients died within 30 days of their operation, giving an overall mortality of 4.3%. 119 patients required CSF diversion during their treatment (27%), 101 of whom required permanent shunting.
Conclusions: Posterior fossa tumour surgery carries a significant risk of mortality, which all patients should be routinely counselled about. The most common associated condition is hydrocephalus, with a quarter of patients requiring CSF diversion along with their tumour resection. The 30 day mortality risks are higher for patients with metastatic carcinoma (10.5% of patients died) and posterior fossa meningiomas (6.5% mortality).
Patient Care: This research provides up to date mortality and return to theatre information from a modern, tertiary referral centre.
Learning Objectives: Participants will be able to better discuss the risks and potential complications of posterior fossa tumour surgery.