Fluorescein Sodium-Guided Neuroendoscopic Resection of Deep-Seated Malignant Brain Tumors: Preliminary Results of 18 Patients
| Autor: | Ozkan Tehli, Çağlar Temiz, Soner Yaşar, Mehmet Can Ezgu, İlker Özer, Mehmet Daneyemez, Yusuf Izci, Murat Kutlay, Cahit Kural, Alpaslan Kırık, Ozan Durmaz |
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| Rok vydání: | 2020 |
| Předmět: |
Malignant Brain Neoplasm
medicine.medical_specialty medicine.diagnostic_test business.industry Brain Neoplasms medicine.medical_treatment Magnetic resonance imaging Glioma Microsurgery medicine.disease Neurosurgical Procedures Endoscopy medicine Humans Surgery Fluorescein Neurology (clinical) Sodium fluorescein Radiology Complication Adverse effect business Fluorescent Dyes |
| Zdroj: | Operative neurosurgery (Hagerstown, Md.). 20(2) |
| ISSN: | 2332-4260 |
| Popis: | Background Deep-seated intracranial lesions are challenging to resect completely and safely. Fluorescence-guided surgery (FGS) promotes the resection of malignant brain tumors (MBTs). Classically, FGS is performed using microscope equipped with a special filter. Fluorescence-guided neuroendoscopic resection of deep-seated brain tumors has not been reported yet. Objective To evaluate the feasibility, safety, and effectiveness of the fluorescence-guided neuroendoscopic surgery in deep-seated MBTs. Methods A total of 18 patients with high-grade glioma (HGG) and metastatic tumor (MT) underwent fluorescein sodium (FS)-guided neuroendoscopic surgery. Tumor removal was carried out using bimanual microsurgical techniques under endoscopic view. The degree of fluorescence staining was classified as "helpful" and "unhelpful" based on surgical observation. Extent of resection was determined using magnetic resonance imaging (MRI). Karnofsky Performance Status (KPS) score was used for evaluation of general physical performances of patients. Results A total of 11 patients had HGG, and 7 had MT. No technical difficulty was encountered regarding the use of endoscopic technique. "Helpful" fluorescence staining was observed in 16 patients and fluorescent tissue was completely removed. Postoperative MRI confirmed gross total resection (88.9%). In 2 patients, FS enhancement was not helpful enough for tumor demarcation and postoperative MRI revealed near total resection (11.1%). No complication, adverse events, or side effects were encountered regarding the use of FS. KPS score of patients was improved at 3-mo follow-up. Conclusion FS-guided endoscopic resection is a feasible technique for deep-seated MBTs. It is safe, effective, and allows for a high rate of resection. Future prospective randomized studies are needed to confirm these preliminary data. |
| Databáze: | OpenAIRE |
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