Is the sitting or the prone position best for surgery for posterior fossa tumours in children?

Background: The aim of this study was to compare complications in children operated for posterior fossa tumours in the sitting position with those in the prone position. Methods: We retrospectively assessed the perioperative course of posterior fossa tumour (PFT) surgery according to the operating position. Sixty children were operated in the sitting position (SP) and 19 in the prone position (PP). Preoperative data were not different between groups. Results: Patients in the PP group received a larger median (95% confidence interval) volume of intraoperative blood transfusion than patients in the SP group [200 (20-325) versus 0 (0-80) ml, P=0.04]. Intraoperative complications, as well as severe perioperative complications were more frequent in the PP group (P=0.01). The median duration of tracheal intubation [20 (18-24) versus 36 (18-72) h, P=0.037], of ICU stay [2 (2-3) versus 4 (2-5) days, P=0.02] and of hospital stay [11 (9-12) versus 14 (10-20) days, P=0.02] was longer in the PP group compared with the SP group. Conclusions: PFT surgery in the sitting position in children is not associated with an increased number or severity of perioperative complications, while the postoperative course appears better in this position.