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Trends in epilepsy surgery in Italy before and after the COVID‐19 pandemic: A nationwide study

Title: Trends in epilepsy surgery in Italy before and after the COVID‐19 pandemic: A nationwide study
Authors: Didato, Giuseppe; Vigevano, Federico; Tassi, Laura; Guerrini, Renzo; de Curtis, Marco; De Palma, Luca; Di Gennaro, Giancarlo; Nobili, Lino; Martinoni, Matteo; Meletti, Stefano; Battaglia, Domenica; Cesaroni, Elisabetta; Vittorini, Roberta; Grisotto, Laura; d'Orsi, Giuseppe; Dilena, Robertino; Pingue, Valeria; Nardone, Antonio; Ranzato, Federica; Zucca, Claudio; Bonanni, Paolo; Mattioli, Pietro; Tamburrini, Gianpiero; Quintiliani, Michela; Luzi, Michele; Trignani, Roberto; Torta, Francesca; Morana, Giovanni; Pugnaghi, Matteo; Vaudano, Anna Elisabetta; Bisulli, Francesca; Pasini, Elena; Consales, Alessandro; Nobile, Giulia; Esposito, Vincenzo; Quarato, Pier Paolo; Freri, Elena; Marras, Carlo Efisio; Giordano, Flavio; Pelliccia, Veronica; Castana, Laura; Specchio, Nicola; Costantino, Umberto; Pluderi, Mauro; Rizzi, Michele; Polo, Diana; Zambrano, Stefania; Danieli, Alberto; Villani, Flavio; Barba, Carmen
Source: Epilepsia ; ISSN 0013-9580 1528-1167
Publisher Information: Wiley
Publication Year: 2025
Collection: Wiley Online Library (Open Access Articles via Crossref)
Description: Objective To study the current practice of epilepsy surgery in Italy and the relative impact of coronavirus disease 2019 (COVID‐19) pandemic on it. Methods We launched a survey through the Italian National Virtual Epilepsy Institute, to identify centers with epilepsy surgery programs and collect data on the current preoperative and surgical practices. We reported changes in surgical volumes and complications and seizure outcomes between 2018 and 2022, that is, before and after the COVID‐19 pandemic in Italy. Results A total of 21 of the 26 surveyed centers (80.7%) responded. Eleven centers (52.4%) reported having an established epilepsy surgery program, with most performing complex procedures, such as multilobar, disconnective, and hemispheric interventions. However, only a few carry out minimally invasive surgeries. Presurgical evaluation protocols vary across centers, but in keeping with international standards. Globally, 618 surgeries were performed in children and 621 in adults (total 1239) between 2018 and 2022. The most frequent type of surgery was unilobar extratemporal lobectomy for children (38.7%, p < 0.0001) and unilobar temporal lobectomy for adults (63.3%, p < 0.0001). Hemispheric surgeries were more frequent in children than in adults (11.5% vs 2.1%, p = 0.001), whereas interventions in unrevealing magnetic resonance (MRI) cases were more frequent in adults than in children ( p = 0.030). At the onset of COVID‐19outbreak in Italy (March 2020), we observed a significant decrease in the total number of operations compared to 2019, especially for hemispheric interventions ( p = 0.027). Surgical volumes resumed in 2021, particularly for temporal lobe epilepsies and in adult cohorts. Surgical complications increased significantly in 2020 (Incidence Rate Ratio [IRR] = 13.13), whereas seizure outcome did not change significantly between 2018 and 2022. Significance Advanced pre‐ and postsurgical evaluation protocols are currently implemented across Italy, with a great variability between ...
Document Type: article in journal/newspaper
Language: English
DOI: 10.1111/epi.18558
Availability: https://doi.org/10.1111/epi.18558; https://onlinelibrary.wiley.com/doi/pdf/10.1111/epi.18558
Rights: http://creativecommons.org/licenses/by-nc/4.0/
Accession Number: edsbas.24F77A4E
Database: BASE