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Wide Dissection Trans-Sulcal Approach for Resection of Deep Intra-Axial Lesions in Eloquent Brain Areas.
Kaye, Brandon; Correa Bastianon Santiago, Raphael Augusto; MacKinnon, Gerard; Dabecco, Rocco; Ibrahim, Bilal; Ali, Assad; Santos, Romel; Johansen, Phillip; Ranjan, Surabhi; Obrzut, Michal; Borghei-Razavi, Hamid; Adada, Badih.
Afiliación
  • Kaye B; Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University, Davie, FL 33328, USA.
  • Correa Bastianon Santiago RA; Department of Neurosurgery, Cleveland Clinic Florida, Weston, FL 33331, USA.
  • MacKinnon G; Department of Neurosurgery, Cleveland Clinic Florida, Weston, FL 33331, USA.
  • Dabecco R; Department of Neurosurgery, Cleveland Clinic Florida, Weston, FL 33331, USA.
  • Ibrahim B; Department of Neurosurgery, Cleveland Clinic Florida, Weston, FL 33331, USA.
  • Ali A; Department of Neurosurgery, Cleveland Clinic Florida, Weston, FL 33331, USA.
  • Santos R; Department of Neurosurgery, Cleveland Clinic Florida, Weston, FL 33331, USA.
  • Johansen P; Department of Neurosurgery, Cleveland Clinic Florida, Weston, FL 33331, USA.
  • Ranjan S; Department of Neurosurgery, Cleveland Clinic Florida, Weston, FL 33331, USA.
  • Obrzut M; Department of Neurosurgery, Cleveland Clinic Florida, Weston, FL 33331, USA.
  • Borghei-Razavi H; Department of Neurosurgery, Cleveland Clinic Florida, Weston, FL 33331, USA.
  • Adada B; Department of Neurosurgery, Cleveland Clinic Florida, Weston, FL 33331, USA.
Curr Oncol ; 29(10): 7396-7410, 2022 10 04.
Article en En | MEDLINE | ID: mdl-36290858
Introduction: Resection of intra-axial tumors (IaT) in eloquent brain regions risks major postoperative neurological deficits. Awake craniotomy is often used to navigate these areas; however, some patients are ineligible for awake procedures. The trans-sulcal approach (TScal) was introduced to reduce parenchymal trauma during tumor resection. We report our experiences utilizing TScal for resection of deep IaT located in eloquent areas. Materials and Methods: This is a single-center retrospective analysis of patients who underwent IaT resection in eloquent areas via TScal from January 2013 to April 2021. Seventeen cases were reviewed, and relevant data was collected. Fluorescence-guided surgery with 5-aminolevulinic acid (ALA) and intraoperative ultrasound was performed in some cases. Results: Seventeen patients (10 males, 7 females) averaging 61.2 years-old (range, 21-76) were included in this study. Average length of stay was 4.8 days, and only 2 patients (11.8%) required hospital readmission within 30 days. Gross total resection (GTR) was achieved in 15 patients (88.2%), while subtotal resection occurred in 2 patients (11.8%). Eleven patients (64.7%) reported full resolution of symptoms, 4 patients (23.5%) reported deficit improvement, and 2 patients (11.8%) experienced no change from their preoperative deficits. No patient developed new permanent deficits postoperatively. Discussion: GTR, preoperative deficit reduction, and complications were comparable to awake craniotomy and other TScal studies. Ancillary intraoperative techniques, such as brain mapping, 5-ALA and intraoperative ultrasound, are afforded by TScal to improve resection rates and overall outcomes. Conclusions: TScal can be an option for patients with deep lesions in eloquent areas who are not candidates for awake surgeries.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Encefálicas / Ácido Aminolevulínico Tipo de estudio: Observational_studies / Qualitative_research / Risk_factors_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Curr Oncol Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Suiza
Texto completo
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Encefálicas / Ácido Aminolevulínico Tipo de estudio: Observational_studies / Qualitative_research / Risk_factors_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Curr Oncol Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Suiza