Pre- and post-operative complications

Abstract

The predominant factor of undergoing glioma surgery is not one of cure, since this cannot be achieved. The main purpose is to establish a definitive diagnosis and to achieve cytoreduction, in order to stabilise and hopefully improve the neurological deficits and also to enable other treatment options (such as radiotherapy and/or chemotherapy) to be more effective, as they have less residual tumour bulk to deal with. However, no surgery is without risks, and this is very much the case with neurosurgery, especially when dealing with gliomas that diffusely infiltrate the surrounding brain tissue, destroying specific functions as they grow and causing irreversible damage to the brain. Wound healing impairment, surgical site infections (SSI) and post-operative morbidity are serious problems in neurosurgery, associated with prolonged inpatient stays, increased costs and patient discomfort. Thirty-day readmission rates have become a proxy for quality of care, contributing significantly to high health-care costs. Helping to reduce surgical complications and improve patient's quality of life is pivotal to neurosurgical nursing. This chapter will therefore explore some of the more common surgical complications associated with glioma surgery (both pre- and post-operatively) and help equip the novice nurse with practical information about how to not only identify surgical problems early but also how to treat them effectively and how to help the patients and their carers cope with long-term side effects and adapt to a new way of living with a life-limiting disease.