RESUMEN
OBJECTIVE: The objective of this study was to report the results of a bibliometric analysis on the modern corpus of literature pertaining to endoscopic third ventriculostomy (ETV). Prior bibliometrics studies on ETV have focused on highly cited articles, but an advanced bibliometric analysis has not yet been conducted. METHODS: The authors queried the Web of Science (WoS) for (ALL = (endoscopic third ventriculostomy)) OR (ALL = (ETV) AND ALL = (neurosurgery)). Articles or reviews published in English were included. Articles, along with their metadata, were exported. Statistical, bibliometric, and network analyses were performed using the Bibliometrix R package and various Python packages. Reference publication year spectroscopy (RPYS), a method that analyzes the frequency with which references are cited in terms of these references' publication years, was employed to explore the historical roots of the field. RESULTS: Between 1994 and 2023, 1663 documents were identified (1382 articles) from 5457 authors. The mean annual growth rate of publications was 4.9%. International coauthorship increased 4-fold over this time period and was noted for 18.95% of published studies from 2011 to 2023. We observed that Child's Nervous System published the most articles, Journal of Neurosurgery (JNS) articles were cited most frequently, and JNS: Pediatrics articles had the highest impact. Female coauthorship increased from < 1% of published studies before 2000 to 19% by 2022, with an increase in female first authorship from 2% in 2005 to 22% in 2022 and at least 1 female coauthor rising from 3% in 2000 to 68% in 2022. Likewise, minority authorship has increased, as in the early ETV literature > 75% of authors were White while currently only 43% are White. The authors of this study also identified the most prolific authors on the subject. Early in the publication record, etiological and technical terms such as "aqueductal stenosis" and "technical note" predominated. More recently, "complications," "failure," "success," "neuroendoscopy," and "choroid plexus cauterization" were prominent. Utilizing RPYS, the authors identified 32 articles that comprise the foundational articles on ETV, published between 1966 and 2010. CONCLUSIONS: Interest in ETV increased in the 1990s with the advent of advanced endoscopic technologies-particularly digital video. The focus of research has shifted from etiology to outcomes, complication management, and technical mastery.
RESUMEN
OBJECTIVE: Controlling length of stay (LOS) reduces rates of nosocomial infections and falls, facilitates earlier return to daily activities, and decreases strain on the healthcare system. Complications following supratentorial tumor resection present early in the postoperative period, thereby enhancing the prospect of safe, early discharge. Here, the authors describe their initial experience with the development and implementation of an Enhanced Recovery After Cranial Surgery (ERACS) pathway following resection of supratentorial tumors in select patients. METHODS: This was a nonrandomized, ambispective quality improvement study of patients undergoing elective craniotomy for supratentorial tumor resection at New York University Langone Health between November 17, 2020, and May 19, 2022. Eligible patients were prospectively enrolled in either the ERACS pathway or the standard pathway. These prospective cohorts were compared to a retrospective cohort of patients who met eligibility criteria for the pathway. Patients in the ERACS pathway cohort were targeted for discharge on postoperative day 2. The primary outcome metric was hospital LOS. Secondary outcome metrics included duration of intensive care unit (ICU) care and rates of 30-day emergency department visits, readmissions, and complications. RESULTS: Over the study period, 188 of 317 patients (59.3%) who underwent supratentorial tumor resection met inclusion criteria for ERACS pathway enrollment. Sixty-three patients were enrolled in the ERACS pathway, and 125 patients completed the standard pathway. The historical cohort consisted of 332 patients who would have been eligible for ERACS enrollment. Patients in the ERACS pathway cohort had a median LOS of 1.93 days compared with 2.92 and 2.88 days for patients in the standard pathway and historical cohort, respectively (p < 0.001). There was a significant reduction in ICU utilization in ERACS pathway patients (16.0 ± 6.53 vs 29.5 ± 53.0 vs 21.8 ± 18.2 hours, p = 0.005). There were no differences in the rates of 30-day emergency department visits (12.7% vs 9.6% vs 10.9%, p = 0.809) and readmissions (4.8% vs 4.0% vs 7.8%, p = 0.279) between groups. CONCLUSIONS: Patients in the ERACS pathway cohort experienced reduced LOS and ICU utilization, with similar rates of adverse outcomes compared to standard pathway patients. The authors' initial experience suggests that an accelerated recovery pathway can be safely implemented following supratentorial tumor resection in select patients.
