Awake Craniotomy in Africa: A Scoping Review of Literature and Proposed Solutions to Tackle Challenges.

Autor:	Mofatteh M; School of Medicine, Dentistry, and Biomedical Sciences, Queen's University Belfast, Belfast, UK., Mashayekhi MS; Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada., Arfaie S; School of Medicine, Dentistry, and Biomedical Sciences, Queen's University Belfast, Belfast, UK.; Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada., Adeleye AO; Department of Surgery, College of Medicine, University of Ibadan, Ibadan, Nigeria., Jolayemi EO; Neurosurgery Unit, Department of Surgery, Evercare Hospital Lagos, Nigeria., Ghomsi NC; Neurosurgery Department, Felix Houphouet Boigny Unversity Abidjan, Cote d'Ivoire., Shlobin NA; Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA., Morsy AA; Department of Neurosurgery, Zagazig University, Zagazig, Egypt., Esene IN; Neurosurgery Division, Faculty of Health Sciences, University of Bamenda, Bambili, Cameroon., Laeke T; Neurosurgery Division, Department of Surgery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia., Awad AK; Faculty of Medicine, Ain-shams University, Cairo, Egypt., Labuschagne JJ; Department of Neurosurgery, University of the Witwatersrand, Johannesburg, South Africa., Ruan R; Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, California, USA., Abebe YN; Department of Neurosurgery, Haramaya University Hiwot Fana Comprehensive Specialized Hospital, Harar, Ethiopia., Jabang JN; Edward Francis Small Teaching Hospital, Banjul, Gambia., Okunlola AI; Department of Surgery, Federal Teaching Hospital Ido Ekiti and Afe Babalola University, Ado Ekiti, Nigeria., Barrie U; Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA., Lekuya HM; Department of Neurosurgery, Makerere University/Mulago Hospital, Kampala, Uganda., Idi Marcel E; Department of Neurosurgery, College of Surgeons of East, Central and Southern Africa/Mulago Hospital, Kampala, Uganda., Kabulo KDM; Department of Neurosurgery, Jason Sendwe General Provincial Hospital, Lubumbashi, Democratic Republic of the Congo., Bankole NDA; Department of Neurosurgery, Hôpital Des Spécialités, WFNS Rabat Training Center For Young, African Neurosurgeons, Faculty of Medicine, Mohammed V University, Rabat, Morocco., Edem IJ; Department of Surgery, College of Human Medicine, Michigan State University, East Lansing, Michigan, USA., Ikwuegbuenyi CA; Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon., Nguembu S; Department of Neurosurgery, Higher Institute of Health Sciences, Université des Montagnes, Bangangté, Cameroon., Zolo Y; Global Surgery Division, University of Cape Town, Cape Town, South Africa., Bernstein M; Division of Neurosurgery, Department of Surgery, University of Toronto, University Health Network, Toronto, Ontario, Canada.; Temmy Latner Center for Palliative Care, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
Jazyk:	angličtina
Zdroj:	Neurosurgery [Neurosurgery] 2023 Aug 01; Vol. 93 (2), pp. 274-291. Date of Electronic Publication: 2023 Mar 24.
DOI:	10.1227/neu.0000000000002453
Abstrakt:	Background: Awake craniotomy (AC) is a common neurosurgical procedure for the resection of lesions in eloquent brain areas, which has the advantage of avoiding general anesthesia to reduce associated complications and costs. A significant resource limitation in low- and middle-income countries constrains the usage of AC. Objective: To review the published literature on AC in African countries, identify challenges, and propose pragmatic solutions by practicing neurosurgeons in Africa. Methods: We conducted a scoping review under Preferred Reporting Items for Systematic Reviews and Meta-Analysis-Scoping Review guidelines across 3 databases (PubMed, Scopus, and Web of Science). English articles investigating AC in Africa were included. Results: Nineteen studies consisting of 396 patients were included. Egypt was the most represented country with 8 studies (42.1%), followed by Nigeria with 6 records (31.6%). Glioma was the most common lesion type, corresponding to 120 of 396 patients (30.3%), followed by epilepsy in 71 patients (17.9%). Awake-awake-awake was the most common protocol used in 7 studies (36.8%). Sixteen studies (84.2%) contained adult patients. The youngest reported AC patient was 11 years old, whereas the oldest one was 92. Nine studies (47.4%) reported infrastructure limitations for performing AC, including the lack of funding, intraoperative monitoring equipment, imaging, medications, and limited human resources. Conclusion: Despite many constraints, AC is being safely performed in low-resource settings. International collaborations among centers are a move forward, but adequate resources and management are essential to make AC an accessible procedure in many more African neurosurgical centers. (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Congress of Neurological Surgeons.)
Databáze:	MEDLINE
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