Surgical considerations for maximal safe resection of exophytic brainstem glioma in the pediatric age group
| Autor: | Ahmed Mohamed Ahmed Alselisly, Ayman Tarek Mahmoud, Abdelrhman Enayet |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Intraoperative ultrasonography Medullary cavity business.industry Retrospective cohort study medicine.disease 030218 nuclear medicine & medical imaging Surgery 03 medical and health sciences 0302 clinical medicine Cerebrospinal fluid medicine Adjuvant therapy Brainstem glioma Extent of resection Histopathology Original Article Neurology (clinical) Brainstem business 030217 neurology & neurosurgery Anaplastic astrocytoma |
| Zdroj: | Surgical Neurology International |
| ISSN: | 2152-7806 2229-5097 |
| Popis: | Background: Brainstem glioma is the leading cause of morbidity and mortality among all central nervous system tumors, especially in childhood as it represents about 20% of all pediatric brain tumors. Therefore, this study aimed to present our experience in a tertiary center in a developing country with limited resources for the surgical management of exophytic brainstem gliomas. Methods: This retrospective study included pediatric patients with brainstem (midbrain, pontine, or medullary) focal or diffuse gliomas whether low or high grade that had dorsal, ventral, or lateral exophytic component who were presented to our hospitals from January 2019 to January 2021. The patients’ data were collected, such as age, sex, preoperative and postoperative clinical condition, radiological data, surgical approach, extent of tumor removal, histopathology, follow-up period, and adjuvant therapy. Results: A total of 23 patients were included in this study. The telovelar approach was used in 17 patients, the supracerebellar infratentorial approach in three patients, and the retrosigmoid, transcerebellar, and occipital transtentorial approach once for each patient. Twenty patients underwent near-total excision, and three underwent subtotal excision. Two-thirds of our cases (17 patients) were low-grade gliomas, with the remaining one-third comprising entirely of either anaplastic astrocytoma (five patients) or glioblastoma multiforme (one patient). The follow-up period of the patients extended from 3 months to 24 months. Conclusion: Exophytic brainstem glioma surgery can result in good outcomes with minimal complications when near-total excision is attempted through a properly chosen approach and adherence to some surgical techniques and considerations. |
| Databáze: | OpenAIRE |
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