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Purpose: Blood transfusion is a common perioperative complication of primary total knee arthroplasty (TKA) that can lead to adverse outcomes, prolonged hospital stays, and increased medical costs. The purpose of our study was to explore the risk factors for blood transfusion and to establish whether operation duration is independently related to blood transfusion risk in patients undergoing primary TKA after adjusting for other covariates. Methods: This was a secondary analysis of data from a retrospective cohort study involving patients who underwent primary TKA in Singapore. The patients' baseline data, comorbidity, and surgical characteristics were collected. The independent variable was operation duration and the dependent variable was blood transfusion events. Patients were divided into three groups according to operation durations (90 and 120 min). Univariate logistic regression was used to explore the risk factors associated with blood transfusion after primary TKA. Multivariate analysis was used to assess the independent effect of operation duration on blood transfusion risk after adjusting for other covariates. Additionally, we performed subgroup analyses to identify specific groups, test the robustness of the relationships, and explore whether there were interactions between the different variables. Furthermore, restricted cubic splines (RCS) were used to identify the relationship between the two variables. Results: A total of 2,562 patients were included in the study, of whom 136 (5.61%) had a transfusion event. Operation durations were 95.55 ± 36.93 and 83.86 ± 26.29 min for blood transfused and non-transfused patients, respectively. Univariate logistic regression analysis showed that age, BMI, ASA status, Hb level, OSA, CHF, creatinine level > 2 mg/dL, and anaesthesia type were risk factors for blood transfusion. After adjusting for all covariates, multivariate logistic regression models showed that operation duration was positively associated with blood transfusion risk (odds ratio [OR] = 1.87, 95% CI = 1.174–2.933, P = 0.007). Compared to patients with an operation duration of less than 90 min, those with an operation duration of more than 120 min had a 2.141-fold increased risk of blood transfusion (OR = 2.141, 95% CI = 1.035–4.265, P = 0.035). Stratified analysis results showed that the association persisted in patients aged > 50 years, Chinese, BMI > 30 kg/m 2, Hb level > 11 g/dL, ASA status levels 2 and 3, general anaesthesia, and unilateral primary TKA. A non-linear (P-non-linear = 0.30) and J-shaped relationship was identified. The risk of transfusion increased as the operation duration decreased or exceeded the inflection point (73.2 min). Conclusion: Our study demonstrated a non-linear and J-shaped relationship between operation duration and blood transfusion events in patients undergoing primary TKA. Blood transfusion risk was the lowest when the operation duration was 73.2 min. A shorter operation duration implies irregular surgical procedures and incomplete intraoperative haemostasis, leading to increased perioperative blood loss and blood transfusion. These results will be useful for clinical decision-making. [ABSTRACT FROM AUTHOR]

Background: It is unclear whether laparoscopic hepatectomy (LH) for hepatolithiasis confers better clinical benefit and lower hospital costs than open hepatectomy (OH). This study aim to evaluate the clinical and economic value of LH versus OH. Methods: Patients undergoing OH or LH for primary hepatolithiasis at Yijishan Hospital of Wannan Medical College between 2015 and 2022 were divided into OH group and LH group. Propensity score matching (PSM) was used to balance the baseline data. Deviation-based cost modelling and weighted average median cost (WAMC) were used to assess and compare the economic value. Results: A total of 853 patients were identified. After exclusions, 403 patients with primary hepatolithiasis underwent anatomical hepatectomy (OH n= 143; LH n =260). PSM resulted in 2 groups of 100 patients each. Although LH required a longer median operation duration compared with OH (285.0 versus 240.0 min, respectively, P< 0.001), LH patients had fewer wound infections, fewer pre-discharge overall complications (26 versus 43%, respectively, P =0.009), and shorter median postoperative hospital stays (8.0 versus 12.0 days, respectively, P< 0.001). No differences were found in blood loss, major complications, stone clearance, and mortality between the two matched groups. However, the median overall hospital cost of LH was significantly higher than that of OH (CNY¥52,196.1 versus 45,349.5, respectively, P =0.007). Although LH patients had shorter median postoperative hospital stays and fewer complications than OH patients, theWAMCwas still higher for the LH group than for the OH group with an increase of CNY ¥9,755.2 per patient undergoing LH. Conclusion: The overall clinical benefit of LH for hepatolithiasis is comparable or even superior to that of OH, but with an economic disadvantage. There is a need to effectively reduce the hospital costs of LH and the gap between costs and diagnosis-related group reimbursement to promote its adoption. [ABSTRACT FROM AUTHOR]

The purpose of the meta‐analysis was to evaluate and compare the risk factors for neurosurgical surgical site infection (SSI) after craniotomy. Using dichotomous or contentious random or fixed effect models, the odds ratio (OR) and mean difference (MD) with 95% confidence intervals (CIs) were computed based on the examination of the meta‐analysis results. Eighteen analyses, covering 11 068 craniotomies between 2001 and 2023, were included in the current meta‐analysis. Subjects with SSIs had a significantly younger age (MD, −2.49; 95% CI, −2.95 to −2.04, p < 0.001), longer operation duration (MD, 10.21; 95% CI, 6.49–13.94, p < 0.001) and longer length of postoperative hospital stay (MD, 1.52; 95% CI, 0.45–2.60, p = 0.006) compared to subjects with no SSI with craniotomy. However, no significant difference was found between craniotomy subjects with SSIs and with no SSI in gender (OR, 0.90; 95% CI, 0.76–1.07, p = 0.23), and combination with other infection (OR, 3.93; 95% CI, 0.28–56.01, p = 0.31). The data that were looked at showed that younger age, longer operation duration and longer length of postoperative hospital stay can be considered as risk factors of SSI in subjects with craniotomy; however, gender and combination with other infections are not. Nonetheless, consideration should be given to their values because several studies only involved a small number of patients, and there are not many studies available for some comparisons. [ABSTRACT FROM AUTHOR]

Abstract Background Operating rooms (ORs) are one of the costliest units in a hospital, therefore the cumulative consequences of any kind of inefficiency in OR management lead to a significant loss of revenue for the hospital, staff dissatisfaction, and patient care disruption. One of the possible solutions to improving OR efficiency is knowing a reliable estimate of the duration of operations. The literature suggests that the current methods used in hospitals, e.g., a surgeon’s estimate for the given surgery or taking the average of only five previous records of the same procedure, have room for improvement. Methods We used over 4 years of elective surgery records (n = 52,171) from one of the major metropolitan hospitals in Australia. We developed robust Machine Learning (ML) approaches to provide a more accurate prediction of operation duration, especially in the absence of surgeon’s estimation. Individual patient characteristics and historic surgery information attributed to medical records were used to train predictive models. A wide range of algorithms such as Extreme Gradient Boosting (XGBoost) and Random Forest (RF) were tested for predicting operation duration. Results The results show that the XGBoost model provided statistically significantly less error than other compared ML models. The XGBoost model also reduced the total absolute error by 6854 min (i.e., about 114 h) compared to the current hospital methods. Conclusion The results indicate the potential of using ML methods for reaching a more accurate estimation of operation duration compared to current methods used in the hospital. In addition, using a set of realistic features in the ML models that are available at the point of OR scheduling enabled the potential deployment of the proposed approach.

Background: Operating rooms (ORs) are one of the costliest units in a hospital, therefore the cumulative consequences of any kind of inefficiency in OR management lead to a significant loss of revenue for the hospital, staff dissatisfaction, and patient care disruption. One of the possible solutions to improving OR efficiency is knowing a reliable estimate of the duration of operations. The literature suggests that the current methods used in hospitals, e.g., a surgeon's estimate for the given surgery or taking the average of only five previous records of the same procedure, have room for improvement. Methods: We used over 4 years of elective surgery records (n = 52,171) from one of the major metropolitan hospitals in Australia. We developed robust Machine Learning (ML) approaches to provide a more accurate prediction of operation duration, especially in the absence of surgeon's estimation. Individual patient characteristics and historic surgery information attributed to medical records were used to train predictive models. A wide range of algorithms such as Extreme Gradient Boosting (XGBoost) and Random Forest (RF) were tested for predicting operation duration. Results: The results show that the XGBoost model provided statistically significantly less error than other compared ML models. The XGBoost model also reduced the total absolute error by 6854 min (i.e., about 114 h) compared to the current hospital methods. Conclusion: The results indicate the potential of using ML methods for reaching a more accurate estimation of operation duration compared to current methods used in the hospital. In addition, using a set of realistic features in the ML models that are available at the point of OR scheduling enabled the potential deployment of the proposed approach. [ABSTRACT FROM AUTHOR]

Objectives: Due to the development of laparoscopy techniques, single-site incision laparoscopic surgery (SILS) has recently been performed at many institutes using only a single-incision transumbilical port. We aimed to carry out a learning curve analysis for SILS for adnexal surgery and validate the short-term surgical outcomes. Material and methods: In total, 214 patients were enrolled in this study. The medical records of patients who underwent SILS for adnexal surgery by an expert surgeon from October 2008 to September 2018 were reviewed and analyzed. Results: The mean age and parity were 33.9 ± 11.5 years and 1.0 ± 1.1, respectively. The mean operation duration was 77.5 ± 22.3 min. In the analysis of the learning curve for single-site incision laparoscopic adnexal surgery, surgical proficiency was defined as the point at which the slope of the learning curve became less steep, which was evident after the 24th operation. No operative complications, conversions to laparotomy or additional trocar insertions were observed. Conclusions: Single-site incision laparoscopic surgery (SILS) for adnexal surgery is a safe technique and does not increase the risk of peri- or postoperative complications. For safe performance of SILS, a certain training period for learning the technique should be required. [ABSTRACT FROM AUTHOR]

Under certain conditions of deck resource allocation, resource allocation strategy affects the operational efficiency of aircraft carrier. This study proposes the deck station allocation problem. Starting from the calculation models of dispatching time and queuing time, a dynamic station allocation strategy based on station index is proposed. The strategy determines a suitable station allocation scheme dynamically according to the current operation conditions. Using genetic algorithm to search for the best weight of station parameters, where the objective is to minimize the deck operation duration. Through simulation experiments, the superiority of the proposed strategy is verified by comparing it with other common strategies in the evaluation index of deck operation duration. Using the proposed strategy can obtain better deck operation duration, and improve the sorties rate of the shipborne aircraft. [ABSTRACT FROM AUTHOR]

Study Design: Retrospective propensity score matching (PSM) study. Objective: To investigate the perioperative outcomes comparing adolescent idiopathic scoliosis (AIS) and adult idiopathic scoliosis (AdIS) patients following posterior spinal fusion (PSF). Methods: 425 female AIS and AdIS patients who were operated (between January 2015 to March 2020) using a dual attending surgeon strategy were stratified into G1 (AIS aged 10-16 years old) and G2 (AdIS > 20 years old). PSM analysis with one-to-one, nearest neighbor matching technique with match tolerance of 0.001 was used to matched 357 AIS patients to 68 AdIS patients. Operation duration, intraoperative blood loss (IBL), blood loss percentage, hemoglobin drift, blood salvaged, postoperative wound length, allogenic blood transfusion requirement, postoperative hospital stay, postoperative Cobb, correction rate and postoperative complications were documented and reported. Results: Following PSM, G1 and G2 each had 50 patients with comparable and balanced covariates. As anticipated, G2 patients were heavier, taller and had higher body mass index compared to G1 patients (P < 0.05). We could not find any significant differences in the perioperative outcome comparing this 2 groups. AIS and AdIS patients had similar operation duration (125.9 ± 27.2 min vs 127.3 ± 37.8 min), IBL (749.8 ± 315.7 ml vs 723.8 ± 342.1 ml) and length of hospital stay (3.3 ± 0.4 days vs 3.5 ± 0.8 days) (P > 0.05). Hemoglobin drift and amount of blood salvaged were comparable (P > 0.05). G2 had stiffer curves. There was a trend toward a lower correction rate in G2 in the immediate postoperative period, however it did not reach statistical significance (61.8 ± 11.2% vs. 66.3 ± 11.6%, P = 0.051). No patients required blood transfusion and none had any postoperative complications. Conclusion: Adolescent and adult female scoliosis patients had comparable perioperative outcome following PSF surgery that was carried out using a dual attending surgeon strategy. [ABSTRACT FROM AUTHOR]

To evaluate the effectiveness of the dacryocystorhinostomy (DCR) operation with physiodispenser in nasolacrimal duct obstruction. Two hundred and twelve eyes from 150 patients with chronic dacryocystitis who had undergone external DCR operation with Kerrison punch were included in Group 1. Two hundred and fourteen eyes from 150 patients with chronic dacryocystitis who had undergone external DCR operation with physiodispenser were included in Group 2. There were no significant differences between the two groups in terms of age and sex (p >.05). Excessive bleeding requiring cauterization was observed in 41 (19%) patients in Group 1 and 8 (3%) patients in Group 2 (p <.05) during surgery. The mean operation duration was 32.36 ± 5.46 (26–42) minutes in the first group and 20.41 ± 4.98 (15–28) minutes in the second group (p <.05). Functional success rate at the end of the second postoperative year was 90.2% in the first group and 92.4% in the second (p >.05). Anatomical success rate at the end of second postoperative year was 95.8% in the first group and 98.1% in the second (p >.05). DCR operation with physiodispenser shortens the operation duration, reduces excessive bleeding, and has high functional and anatomical success rates. [ABSTRACT FROM AUTHOR]

In the presented randomized study, laparoscopic cholecystectomy has been performed on 50 patients with acute cholecystitis (experimental group) and 50 patients undergoing laparoscopic cholecystectomy as an elective procedure (control group). There were 35 male and 65 female patients. The average age of the patients was 59 years (56-68 years). In the experimental group, the laparoscopic cholecystectomy was performed within 72 hours from the moment of admission. Both groups were observed and data recorded as regards to demographic data, body mass index, presence or absence of fever, white blood cell count, CRP and ultrasound findings. The operation lasted 35 versus 50 minutes. In the experimental group 6% of the patients developed local complications, while the same happened to only 4% of the patients in the control group. There was a significant difference in the length of time spent at the hospital after the operation (5 days for the experimental group and only 2 for the control group). None of the patients died during this study. Laparoscopic cholecystectomy for treating acute cholecystitis in a carefully selected group of patients, performed during the initial hospital admission, is a safe method associated with acceptable morbidity. It should be performed as soon as possible, preferably within the first 72 hours after admission.

Background: Multiple studies have reported that gender, pre-operative stent insertion, positive pre-operative urine culture results, and diabetes mellitus are associated with infectious complication after ureteroscopy. A previous meta-analysis focused on this topic is based, however, on crude estimate. Further analysis based on adjusted estimates is needed. Methods: PubMed, Web of Science, Embase, and the Cochrane Library database were searched with ureteroscopy, ureteroscopies, ureteroscopic surgical procedures, ureteroscopic surgery, ureteroscopic lithotripsy, flexible ureteroscopic lithotripsy, ureteroscopy (URS), flexible ureterorenoscopy, risk factor, predictor, predicting model, and nomogram until December 15, 2019. The quality of research was evaluated by Newcastle-Ottawa Scale system. Odds ratio (OR) and 95% confidence intervals (CI) of each risk factor were extracted. Meta-analysis was performed with Stata 15.0 software. Heterogeneity was assessed by I2. Publication bias was tested by the Egger test, and funnel plot. Meta-regressions and subgroup analysis were further performed. Results: There were 16 studies; 12,357 patients finally were included in this meta-analysis. The association between gender (OR = 1.82, 95% CI: 1.48-2.23, I2 = 0%, p = 0.701), pre-operative ureteric stent insertion (OR = 1.91, 95% CI: 1.26-2.91, I2 = 40.4%, p = 0.109), diabetes mellitus (OR: 1.40, 95% CI: 1.07-1.85, I2 = 34.1%, p = 0.168), positive urine culture before URS (OR: 2.18, 95% CI: 1.34-3.57, I2 = 47.2%, p = 0.092), operation duration (OR: 1.03, 95% CI: 1.01-1.04, I2 = 70.6%, p = 0.001) and infectious complications was positively significant. All four pooled results were different from results of meta-analysis based on crude estimate. Conclusion: Female gender, pre-operative ureteric stent insertion, diabetes mellitus, positive urine culture results before URS, and operation duration are risk factors for infectious complications after URS. Meta-analysis based on adjusted estimates may be more convincing. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to compare the duration of surgery and anesthesia, complication rates and the amount of anesthetic drugs used and the cost in laparoscopic tubal ligation cases with and without the use of manipulator. This retrospective case control study included the women who underwent elective interval laparoscopic tubal ligation. Material and Methods: The time between intubation and the onset of surgery, duration of surgery (main operation time) and intubation-extubation (total operation time-duration of anesthesia) were recorded in the operating room. Results: Demographic datas were similar between the patients with and without manipulators (p> 0.05). In the non-manipulator group, intubation to beginning of surgery time, main operation time, total anesthesia time were found to be shorter (p <0.001, p <0.001, p <0.001, respectively). Postoperative hospital stay, the amount of parenteral anesthetic drug used, the need for postoperative parenteral analgesics, the number of laparoscopic ports used and the complication rates were similar between the two groups (p> 0.05). Sevoflurane use was found to be less in the non-manipulator group (p <0.001). Conclusions: In laparoscopic tubal ligation operation where no uterine manipulator is used, anesthesia and total surgery times are approximately 8 minutes shorter. The use of uterine manipulator increases the duration of surgery and the amount of sevoflurane used. Laparoscopic tubal ligation without uterine manipulator may be considered in cases where severe adhesions are not anticipated and no additional intervention is planned. Besides, avoidance of manipulator use may have the advantage of time and cost savings. [ABSTRACT FROM AUTHOR]

Amaç: Bu çalışmanın amacı laparoskopik histerektominin (LH) klinik sonuçlarını değerlendirmektir.Gereç ve Yöntem: Bu retrospektif çalışmada, Ocak 2010 ile Aralık 2016 arasında LH uygulanan 511 hastanın orijinal dosyaları incelendi. Yaş ortalamaları, vücut kütle indeksi (VKİ), doğum sayısı, ameliyat endikasyonları, uterus ağırlığı, operasyon süresi, kan kaybı, hastanede kalma süresi, analjezik ihtiyaçları, intraoperatif veya postoperatif komplikasyonlar kaydedildi ve yıllara göre değerlendirildi.Bulgular: En düşük LH oranı %10.14 ile 2012 yılında, en yüksek oran % 47.73 ile 2016 yılında idi. Medikal tedaviye dirençli uterin myom (%31.51) ve menometroraji (%25.63) en sık görülen endikasyonlardı. Değerlendirilen süre içerisinde yaş, VKİ, doğum sayısı, kan kaybı, analjezik gereksinimi, uterus ağırlığı, önceden karın içi cerrahi operasyon geçirme oranı, laparoskopiden laparatomiye dönüşüm oranı, intraoperatif veya postoperatif komplikasyonlar açısından fark yoktu. Ancak ameliyat süresi ve hastanede kalış süresi ilk 3 yıldan sonra önemli ölçüde azalmıştı.Sonuç: Jinekolojik cerrahlar için endoskopi eğitimine, teknolojik gelişmelere ve cerrahi tekniklerin kullanımına verilen önem LH sonrası iyileşmeyi geliştirmiş ve hastanede kalış süresini kısaltmıştır. LH hasta için etkin ve güvenli olduğundan histerektomi endikasyonlarında tercih edilen cerrahi seçenek olmalıdır.

Aim: Examining the effect of surgeon's fatigue on early term patency and complications of arteriovenous fistula (AVF). Material and Methods: AVFs created for hemodialysis in patients with end-stage renal failure were included in the study. The patients were divided into 2 groups as those operated in the first operation of that day (Group 1) and those operated after the first or second operations (Group 2). The patients were compared with respect to clinical, demographics, postoperative, surgical variables, and operation duration. Results: A total of 100 patients underwent AVF operation. No statistically significant differences were found between the groups with respect to clinical, demographic, surgical, and postoperative variables. Efficiency of dialysis was found to be higher and complication rate lower in Group 1. But no statistical significance was obtained in terms of early dialysis efficiency and complication rates in between the groups (p>0.05). Complication rate was higher in Group 2 when compared according to operation time as 120, 120-240, and 240< minutes. But no statistical significance was obtained in this manner (p>0.05). Conclusions: Although not statistically significant, surgical fatigue factor and long operation time increase the rate of early complications and reduce early dialysis efficiency. We think that early term patency of AVF can also be affected by the complication rate. The effect of this variable can be statistically significant with studies having larger sample size. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate the clinical results of laparoscopic hysterectomy (LH). Materials and Methods: In this retrospective study, the original files of 511 patients who underwent LH between January 2010 and December 2016 were analyzed. The following parameters were recorded and assessed according to the years studied: mean age, body mass index (BMI), parity, indications for surgery, uterine weight, operation duration, blood loss, duration of hospitalization, analgesic needs, and intra- and post-operative complications. Results: The lowest LH rate was 10.14% in 2012, and the highest rate was 47.73% in 2016. Uterine myoma (31.51%) and menometrorrhagia (25.63%) resistant to medical treatment were the most common indications. There were no differences in terms of age, BMI, parity, blood loss, analgesic requirements, uterus weight, previous intra-abdominal surgery rate, laparoscopy to laparatomy conversion rate, and intra- or post-operative complications during the period assessed. However, operation time and hospital stay durations were significantly reduced after the first 3 years. Conclusion: An emphasis on endoscopy training for gynecological surgeons, along with technological advances and the use of surgical techniques, has improved postoperative LH recovery, and the length of the required hospital stay has become shorter. LH should be the preferred surgical option in hysterectomy indications, as it is effective and safe for the patient. [ABSTRACT FROM AUTHOR]

Background: Working in the operating room is characterized by high demands and overall workload of the surgical team. Surgeons often report that they feel more stressed when operating as a primary surgeon than in the function as an assistant which has been confirmed in recent studies. In this study, intra-individual workload was assessed in both intraoperative functions using a multidimensional approach that combined objective and subjective measures in a realistic work setting. Methods: Surgeons' intraoperative psychophysiologic workload was assessed through a mobile health system. 25 surgeons agreed to take part in the 24-hour monitoring by giving their written informed consent. The mobile health system contained a sensor electronic module integrated in a chest belt and measuring physiological parameters such as heart rate (HR), breathing rate (BR), and skin temperature. Subjective workload was assessed pre- and postoperatively using an electronic version of the NASA-TLX on a smartphone. The smartphone served as a communication unit and transferred objective and subjective measures to a communication server where data were stored and analyzed. Results: Working as a primary surgeon did not result in higher workload. Neither NASA-TLX ratings nor physiological workload indicators were related to intraoperative function. In contrast, length of surgeries had a significant impact on intraoperative physical demands ( p < 0.05; η = 0.283), temporal demands ( p < 0.05; η = 0.260), effort ( p < 0.05; η = 0.287), and NASA-TLX sum score ( p < 0.01; η = 0.287). Conclusions: Intra-individual workload differences do not relate to intraoperative role of surgeons when length of surgery is considered as covariate. An intelligent operating management that considers the length of surgeries by implementing short breaks could contribute to the optimization of intraoperative workload and the preservation of surgeons' health, respectively. The value of mobile health systems for continuous psychophysiologic workload assessment was shown. [ABSTRACT FROM AUTHOR]

Objectives: Due to the development of laparoscopy techniques, single-site incision laparoscopic surgery (SILS) has recently been performed at many institutes using only a single-incision transumbilical port. We aimed to carry out a learning curve analysis for SILS for adnexal surgery and validate the short-term surgical outcomes., Material: AND METHODS: In total, 214 patients were enrolled in this study. The medical records of patients who underwent SILS for adnexal surgery by an expert surgeon from October 2008 to September 2018 were reviewed and analyzed., Results: The mean age and parity were 33.9 ± 11.5 years and 1.0 ± 1.1, respectively. The mean operation duration was 77.5 ± 22.3 min. In the analysis of the learning curve for single-site incision laparoscopic adnexal surgery, surgical proficiency was defined as the point at which the slope of the learning curve became less steep, which was evident after the 24th operation. No operative complications, conversions to laparotomy or additional trocar insertions were observed., Conclusions: Single-site incision laparoscopic surgery (SILS) for adnexal surgery is a safe technique and does not increase the risk of peri- or postoperative complications. For safe performance of SILS, a certain training period for learning the technique should be required.

Abstract: Background: Patient-specific approach design, comprehensive evaluation on perioperative data, and follow-up of postoperative life quality (KPS) were carried out to evaluate the application of VR technology of Dextroscope in procedures of patients with skull base tumors. Methods: Eighty-four patients with skull base tumors involved in this research were randomized into 2 groups (test group and control group), each with 42 patients. Before operation, image data such as MR, MRA, or CTA of head were collected and imported into the Dextroscope workstation. The detailed preoperative plans were made in the test group, but no Dextroscope plans in control group. The resection rate of tumors, preoperative evaluation including the duration of operation, total blood loss, the postoperative LOS, the number of cases with cerebrovascular injury complications in operation, and postoperative KPS of patients on discharge and the sixth month follow-up in the 2 groups were recorded and compared. Results: The total resection rate of tumors was 83.33% in test group and 71.42% in the control group (P > .05). The total resection rate of meningioma was 86.67% in test group and 76.47% in control group. The total resection rates of trigeminal Schwannoma in the 2 groups were all 100% (P > .05). The duration of operation and the postoperative LOS of each patient were 5.25 ± 0.64 hours and 8.50 ± 1.10 days in the test group and 7.36 ± 0.87 hours and 12.50 ± 1.52 days in the control group, respectively (P < .05). Total blood loss of each patient was 456.75 ± 55.76 mL in the test group and 523.85 ± 66.78 mL in the control group (P > 05). There were 3 cases with complications of cerebral vessels injury in the test group and 7 cases in the control group (P < .05). During follow-up, KPS of patients in the test group on discharge (85.75 ± 9.68) was significantly superior to that in the control group (81.66 ± 9.24; P < .05). The KPS of patients on the sixth-month follow-up in the test group was 92.35 ± 9.95, which was significantly superior to that in the control group (85.6 ± 9.34; P < .05). Karnofsky performance scores of patients in the test group improved significantly from discharge to the sixth month after procedure (P < .05), whereas there were adverse results in the test group (P < .05). The 2 cases with CSF leakage were cured completely. Conclusion: The preoperative plans with VR technology in patients with skull base tumor or CSF leakage operations can help certain the diagnosis, individually locate the position of skull base lesions, and design patient-specific approach, which also facilitate to shorten operation duration and the postoperative LOS, reduce total blood loss and injury of vessels in operation, and improve the postoperative KPS. [Copyright &y& Elsevier]