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Surgery for primary brain tumors at United States
academic training centers: results from the Residency Review Committee for
neurological surgery
Jane
JA Jr, Sulton
LD, Laws
ER Jr
Department of Neurological Surgery, University of Virginia Health System,
Charlottesville, Virginia 22908, USA.
Object. Surgery for primary brain tumors has been an important index of the
quality of neurosurgical training programs in the US.
The scope of such
cases and the proportion of surgeries performed transsphenoidally are an
interesting means of tracking the effectiveness of residency education.
Methods. Program Information Forms from the 94 American Council for Graduate
Medical Education-approved US neurosurgical residency programs were reviewed
for the period between 2000 and 2003.
Particular attention was focused on an
analysis of the cases requiring craniotomy for primary brain tumor and
transsphenoidal surgery.
The mean annual number of primary brain tumor cases
per program was 195, with a range from 36 to 724 cases.
The proportion of
primary brain tumors accessed transsphenoidally was 20%.
The mean annual
number of transsphenoidal operations performed at academic training centers
was 39.
A wide range in the frequency of transsphenoidal cases from one
program to another was also noted.
Almost one third of training centers
performed fewer than 20 transsphenoidal operations annually and 80%
performed fewer than 50.
Conclusions. Most neurosurgical training programs
provide residents with excellent experience in craniotomy for primary brain
tumors.
Practice with transsphenoidal surgery, however, is less well
represented and tends to be clustered at several active centers.
The
implications for neurosurgical education are significant.
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