Minimally invasive keyhole temporal lobectomy approach for supramaximal glioma resection: A safety and feasibility study
| Autor: | Veronica Bowory, Ashish H. Shah, Michael E. Ivan, Daniel G Eichberg, Simon Buttrick, Ricardo J. Komotar, Angela M. Richardson, Alexis Morell, Christopher A. Sarkiss, Javier Figueroa |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Hemispherectomy medicine.medical_treatment Extent of resection Resection Temporal lobe Stereotaxic Techniques 03 medical and health sciences 0302 clinical medicine Postoperative Complications Physiology (medical) Glioma medicine Humans Wakefulness Craniotomy Aged Retrospective Studies Temporal lobectomy business.industry Brain Neoplasms General Medicine Cytoreduction Surgical Procedures Middle Aged medicine.disease Temporal Lobe Psychosurgery Neurology 030220 oncology & carcinogenesis Near total resection Feasibility Studies Surgery Female Neurology (clinical) Radiology Neoplasm Recurrence Local business Keyhole 030217 neurology & neurosurgery |
| Zdroj: | Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia. 72 |
| ISSN: | 1532-2653 |
| Popis: | With a recent trend towards supra-maximal resection for gliomas and minimally invasive techniques, keyhole temporal lobectomies may serve an important role in neurosurgical oncology. Due to their location and proximity to eloquent brain, temporal lobe gliomas offer unique challenges that may limit the extent of resection. Here we describe a modified technique using mini-craniotomies through a keyhole approach for temporal lobectomies in glioma patients. We retrospectively reviewed data from consecutive patients who underwent temporal lobectomies for resection of gliomas from 2012 to 2018. Demographic data, extent of tumor resection, pre and post-op KPS, short term and long term complications, as well as other relevant data were collected. We identified 57 patients who underwent keyhole-mini craniotomy for temporal lobectomies for glioma. Surgical procedures were performed in 12 patients for low-grade glioma (LGG) and 45 patients for high-grade glioma (HGG). Awake craniotomies were performed in 15 of the cases, and 13 cases were for tumor recurrence. Supra-maximal resection (SMR) was achieved in 15 patients, while gross total resection (GTR) and near total resection (NTR) achieved in 32 patients and 10 patients, respectively. Average pre- and post-op KPS were equivalent, and post-operative complications requiring surgical intervention were experienced in 4 patients. Here we show that our modified keyhole craniotomy is both safe and effective in achieving SMR or GTR in glioma patients, with minimal morbidity. This minimally-invasive temporal lobectomy may be an instrumental tool for neurosurgical oncologists transitioning to less invasive techniques. |
| Databáze: | OpenAIRE |
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