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Military neurosurgery in operation: experience in the French role-3 medical treatment facility of Kabul

  • Clinical Article - Brain Injury
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Abstract

Background

In 2009, during the war in Afghanistan, the increasing number of head injuries led to the deployment of a military neurosurgeon at the Kabul International Airport (KaIA) medical treatment facility, in March 2010. The main goal of this study was to depict the neurosurgical activity in this centre and to analyse its different aspects.

Method

A retrospective study of all the neurosurgical patients treated in KaIA from March 2010 to June 2013.

Results

Three hundred and seventy-three interventions performed by the neurosurgeon deployed were reported for 373 surgeries, in 335 patients, representing 10.6 % of the overall surgical activity of the centre. Among the 69 interventions performed on soldiers, 57 surgeries were undertaken in emergency (82.6 %), while 12 were elective procedures (17.4 %). On the other hand, 289 surgeries were performed in civilian Afghans, with 126 emergency procedures in (43.6 %), against 163 elective interventions (56.4 %). Among the 44.5 % (n = 149) of the traumatic casualties, cerebral lesions represented 28.7 % (n = 96) and spinal lesions 12.4 % (n = 42). Ninety patients had multiple injuries. Additionally, patients without trauma accounted for 55.5 % (n = 186) of the overall population. Thus, 49 % (n = 164) were operated on for non-traumatic lesion of the spine. These were mostly civilian Afghans treated under medical aid to the population (90.2 %, n = 148/164).

Conclusions

The military neurosurgeon had two roles in KaIA: both to support the armed forces and to manage medical aid to the civilian population. This study gives food for thought on the neurosurgical needs in modern warfare, and on the skills required for the military neurosurgeon.

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Acknowledgements

Military neurosurgeons deployed during the period of the study:

• Médecin en Chef Renaud DULOU, French Military Health Service Academy – Ecole du Val-de-Grâce – Paris, Neurosurgery Department, Percy Military Hospital/Hôpital d’Instruction des Armées Percy, France.

• Médecin en Chef Jean-Marc DELMAS, Neurosurgery Department, Percy Military Hospital/Hôpital d’Instruction des Armées Percy, France.

• Médecin en Chef Olivier GOASGUEN, Neurosurgery Department, Val-de-Grâce Military Hospital/Hôpital d’Instruction des Armées du Val-de-Grâce, France.

• Médecin en Chef Eric BLONDET, Neurosurgery department, Val-de-Grâce Military Hospital/Hôpital d’Instruction des Armées du Val-de-Grâce, France.

• Médecin Chef des Services de Classe Normale Jean-Bernard BILLANT, Neurosurgery Department, Sainte Anne Military Hospital/Hôpital d’Instruction des Armées Sainte Anne, France.

• Médecin en Chef Naaman AOUAD, Neurosurgery Department, Sainte Anne Military Hospital/Hôpital d’Instruction des Armées Sainte Anne, France.

• Médecin en Chef Cédric BERNARD, Neurosurgery Department, Sainte Anne Military Hospital/Hôpital d’Instruction des Armées Sainte Anne, France.

• Médecin en Chef Arnaud DAGAIN, French Military Health Service Academy – Ecole du Val-de-Grâce – Paris, Neurosurgery Department, Sainte Anne Military Hospital/Hôpital d’Instruction des Armées Sainte Anne, France.

• Lieutenant-Colonel Colin SHIEFF, 306 Hospital Support Medical Regiment, United Kingdom.

• Lieutenant-Colonel, Professor Dr. Uwe Max MAUER, Chairman Military Committee World Federation of Neurosurgical Societies, Department of Neurosurgery, Germany.

• Lieutenant-Colonel Gregor FREUDE, German Armed Forces Hospital of Ulm, Ulm, Germany.

• Lieutenant-Colonel, Ilia LEVIKOV, German Federal Armed Forces Central Hospital Koblenz, Germany.

Author information

Authors and Affiliations

  1. Neurosurgery Department, Sainte Anne Military Hospital/Hôpital d’Instruction des Armées Sainte Anne, 83000, Toulon, France

    Christophe Joubert & Nicolas Desse

  2. French Military Health Service Academy – Ecole du Val-de-Grâce – Paris, Neurosurgery Department, Percy Military Hospital/Hôpital d’Instruction des Armées Percy, 92140, Clamart, France

    Renaud Dulou

  3. Neurosurgery Department, Percy Military Hospital/Hôpital d’Instruction des Armées Percy, 92140, Clamart, France

    Jean Marc Delmas & Mathilde Fouet

  4. French Military Health Service Academy – Ecole du Val-de-Grâce – Paris, Neurosurgery Department, Sainte Anne Military Hospital/Hôpital d’Instruction des Armées Sainte Anne, 83000, Toulon, France

    Arnaud Dagain

Authors
  1. Christophe Joubert
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  2. Renaud Dulou
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  3. Jean Marc Delmas
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  4. Nicolas Desse
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  5. Mathilde Fouet
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  6. Arnaud Dagain
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Corresponding author

Correspondence to Arnaud Dagain.

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Funding

No funding was received for this research.

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organisation or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

Additional information

The opinions or assertions expressed herein are the private views of the authors and are not to be considered as official or as reflecting the views of the French Military Health Service.

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Joubert, C., Dulou, R., Delmas, J.M. et al. Military neurosurgery in operation: experience in the French role-3 medical treatment facility of Kabul. Acta Neurochir 158, 1453–1463 (2016). https://doi.org/10.1007/s00701-016-2843-z

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  • DOI: https://doi.org/10.1007/s00701-016-2843-z

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