Neuronavigator-guided glioma surgery

来源 :Chinese Medical Journal | 被引量 : 0次 | 上传用户:Jordan2391
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Objective To evaluate the effectiveness of neuronavigator-guided surgery for the resection of gliomas. Methods A total of 80 patients with gliomas underwent surgical treatment under the StealthStation neuronavigator to estimate the extent of the tumors. In 27 cases,the measurements of brain shifts at the dura,cortical surface and lesion margin were recorded during the operations. A technique termed “micro-catheter fence post” was used in superficial gliomas to compensate for brain shift.Results Mean fiducial error and predicted accuracy in the 80 cases were 2.03 mm±0.89 mm and 2.43 mm±0.99 mm,respectively. The shifts at the dura,cortical surface and lesion margin were 3.44 mm±2.39 mm,7.58 mm±3.75 mm,and 6.55 mm±3.19 mm,respectively. Although neuronavigation revealed residual tumors,operations were discontinued in 5 cases of deep-seated gliomas. In the other 75 cases,total tumor removals were achieved in 62 (82.7%),and subtotal removals were achieved in 13 (17.3%). Post-operation,neurological symptoms were improved or unchanged in 68 cases (85.0%),and worsened in 12 (15.0%). No deaths occurred during the operations and post-operations. Conclusions Intraoperative brain shifts mainly contribute to the fail of spatial accuracy during neuronavigator-guided glioma surgery. The “micro-catheter fence post” technique used for glioma surgery is shown to be useful for compensating for intraoperative brain shifts. This technique,thus,contributes to an increase in total tumor removal and a decrease in surgical complications. Objective To evaluate the effectiveness of neuronavigator-guided surgery for the resection of gliomas. Methods A total of 80 patients with gliomas underwent surgical treatment under the StealthStation neuronavigator to estimate the extent of the tumors. In 27 cases, the measurements of brain shifts at the dura, cortical surface and lesion margin were recorded during the operations. A technique termed “micro-catheter fence post” was used in superficial gliomas to compensate for brain shift. Results were fiducial error and predicted accuracy in the 80 cases were 2.03 mm ± 0.89 The shifts at the dura, cortical surface and lesion margin were 3.44 mm ± 2.39 mm, 7.58 mm ± 3.75 mm, and 6.55 mm ± 3.19 mm, respectively. However, neuronavigation revealed residual tumors, operations were discontinued in 5 cases of deep-seated gliomas. In the other 75 cases, total tumor removals were achieved in 62 (82.7%), and subtotal removals were achieved in 13 (17.3%). Post-operatio n tion, neurogenic symptoms were improved or unchanged in 68 cases (85.0%), and worsened in 12 (15.0%). No deaths occurred during the operations and post-operations. Conclusions Intraoperative brain shifts mainly contribute to the fail of spatial accuracy during neuronavigator -guided glioma surgery. The “micro-catheter fence post” technique used for glioma surgery is shown to be useful for compensating for intraoperative brain shifts. This technique, thus, contributes to an increase in total tumor removal and a decrease in surgical complications.
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