INITIAL EXPERIENCE WITH STEREOTACTIC SURGERY IN WEST AFRICA

BACKGROUND The first stereotactic surgery program in West Africa was established in Ghana in 1999. OBJECTIVE This study presents a retrospective evaluation of the pattern and outcome of the first seventeen consecutive stereotactic procedures. It also discusses the benefits, challenges and prospects of the program in West Africa. METHODES 17 patients (11F, 6M) with CT disclosure of intracranial mass lesions that could be assessed or managed stereotactically to the patients benefit (9,10). underwent stereotactic procedures during a consecutive 18-month period. Analysis of charts, relevant imaging studies and pathology reports were done. RESULT The average age of the patients was 37 years (range 2-72years). 71% had a preoperative diagnosis of brain tumor; 83.3% were confirmed. All the procedures were performed in the supratentorial compartment. A biopsy was done in every case. 35% underwent biopsy and aspiration/evacuation. The mean CT scan time was 18 minutes (range 5-48minutes). The mean operating room time was 37 minutes (range 30-43minutes). All the cases were done utilizing local anesthesia and intravenous sedation. The average length of hospital stay was 2.7days (range 2-7 days). Histopathologic results showed Arachnoid cyst (2), Neoplasms (10), infection (1), Intraaxial hematoma (2), Thrombosis (1), Normal tissue (1). The failed biopsy rate was 6%. The surgical objectives were achieved without complications. No blood transfusions were given or required. Stereotactic procedures cost 50-59% less than conventional surgery. CONCLUSION It is concluded that the initial experience with stereotactic surgery in West Africa consists of utilizing the Leksell Stereotactic System for the safe performance of tumor biopsies and aspirations/evacuations with reduction in health care costs compared to conventional surger