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Jay D. Law, Ralph A. W. Lehman and Wolff M. Kirsch

A lthough usually successful, lumbar disc surgery fails to provide adequate long-term pain relief for 8% to 25% of patients. 1, 5, 6, 8, 10, 12–14 Such patients often continue to suffer with persistent or recurrent back pain and sciatica despite prolonged attempts at nonsurgical therapy. When these measures fail, the possibility of attempting another operation arises. We warn those patients whom we consider candidates for further surgery that the likelihood that reoperation will relieve their pain is less than at the original surgery. However, we have been

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Rajesh K. Bindal, Raymond Sawaya, Milam E. Leavens, Kenneth R. Hess and Sarah H. Taylor

survival. Recently, we showed that selected patients with multiple brain metastases should also be treated with surgery. 1 Unfortunately, 31% to 48% of surgically treated patients will develop recurrence in the brain. 1, 4, 12, 14 Little is known about the prognosis and results after reoperation for such patients. 15 Clinical Material and Methods We present 48 patients who underwent reoperation for recurrent brain metastases at M. D. Anderson Cancer Center between January 1984 and April 1993. Only patients who initially underwent surgical removal of all lesions

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Isabelle M. Germano, Nicole Poulin and André Olivier

S eizures recur after surgery for temporal lobe epilepsy in 20% to 60% of patients. 3, 5, 8, 12, 20 Although epilepsy surgery is practiced in an increasing number of centers, the indications for and the risks and outcome of reoperation for temporal lobe epilepsy have not been well documented. Reoperation for epilepsy was first reported in 1954 by Penfield and Jasper. 13 Several more recent series have demonstrated the benefit of reoperation for recurrent seizures, 14 including those of temporal lobe origin; 3, 12, 20 25% to 52% of patients were seizure

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Anil K. Roy, Jason Chu, Caroline Bozeman, Samir Sarda, Michael Sawvel and Joshua J. Chern

T hirty-day readmission and reoperation rates have been used as quality indicators across surgical specialties. 1 , 2 , 4–6 , 8–12 , 14 This relatively long time interval (30 days) enables one to capture complications resulting from complex interplays among preoperative, intraoperative, and postoperative factors following the index surgery. For example, surgical infection could be a direct result of breaches of proper sterile technique, but it could also result from poor wound care or lack of access to medical care. Determining the relative contributions of

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Ramin A. Morshed, Jacob S. Young, Seunggu J. Han, Shawn L. Hervey-Jumper and Mitchel S. Berger

rates, and technical challenges that arose in a cohort of patients undergoing reoperation for recurrent insular gliomas. Methods Patient Selection and Characteristics After obtaining approval from the IRB of the University of California, San Francisco (UCSF), a search query was performed through the UCSF tumor registry to include patients with a pathologic diagnosis of a glioma (WHO grades II–IV) located within the insular region who underwent an index resection followed by reoperation. Patients were excluded if their glioma involved any part of the insula but

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Marjut Lepänluoma, Melissa Rahi, Riikka Takala, Eliisa Löyttyniemi and Tuija S. Ikonen

T he WHO surgical checklist has been studied widely, and its use has been proven to reduce complications and mortality in diverse surroundings and surgical specialties, 1 , 6 , 19 , 23 , 24 although in neurosurgery there is only limited research on the topic. 11 Depending on the type of neurosurgical operation, various studies suggest that adverse event and mortality rates vary between 2%–73.5% and 0%–2.3%, respectively. 3 , 4 , 10 , 20 , 27–30 Complications may lead to reoperations, with a reported incidence of reoperation rates of 1.5%–4.3%. 10 , 17

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Osama Muthaffar, Klajdi Puka, Luc Rubinger, Cristina Go, O. Carter Snead III, James T. Rutka and Elysa Widjaja

patients may benefit from a second surgery excising the remaining epileptogenic tissue. Indeed, of the 6%–23% of patients who undergo reoperation, 9.5%–87% attain seizure freedom. 2 , 5 , 9 , 17 , 21 , 23 , 26 , 29 , 33 However, this rate of seizure freedom should be considered with caution as the patients who undergo reoperation were judged to be eligible for reoperation and had a good chance of attaining seizure control. Additionally, patient characteristics and surgery type greatly influence outcomes. Prior studies have shown that predictors of favorable seizure

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Justin K. Scheer, Jessica A. Tang, Justin S. Smith, Eric Klineberg, Robert A. Hart, Gregory M. Mundis Jr., Douglas C. Burton, Richard Hostin, Michael F. O'Brien, Shay Bess, Khaled M. Kebaish, Vedat Deviren, Virginie Lafage, Frank Schwab, Christopher I. Shaffrey, Christopher P. Ames and the International Spine Study Group

M anagement of adult spinal deformity poses great challenges to the surgeon and has historically been associated with relatively high rates of complications and the need for reoperation. 20 Studies have documented the complications that arise, assessing the rates of reoperation, analyzing factors that increase the likelihood of reoperation, and suggesting methods to prevent the need for reoperation. These studies not only reported complications following primary spine surgery 3 , 8 but also compared complication rates between different types of spine

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Nancy McLaughlin, Peng Jin and Neil A. Martin

entities and procedures. 25 Importantly, neurosurgery has relatively high morbidity and mortality rates in comparison with other surgical specialties. 15 Review of morbidities and mortality has been the primary method of assessing surgical quality used by physicians, hospitals, and oversight agencies. 10 , 17 , 20 In recent years, the reoperation rate, defined as the percentage of patients undergoing a new operation, has been proposed as a quality indicator, a surrogate for surgical adverse events. 4 , 13 , 19 , 24 General surgery has been at the fore-front of

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Lara E. Jehi, Diosely C. Silveira, William Bingaman and Imad Najm

usually based on repeat VEEG and imaging studies, with reoperation performed mostly in the first 2 groups. Previous studies of patients being evaluated for a reoperation after failed temporal lobectomy were either mostly descriptive, with no identification of surgical outcome predictors, 8 , 9 , 24 or highly selective, including only patients with MTS, limiting generalizability of their findings to other TLE pathologies. 21 Some of these studies included mixed cohorts of patients who had undergone temporal surgery and patients who had undergone extratemporal surgery