scholarly journals New Hope in Brain Glioma Surgery: The Role of Intraoperative Ultrasound. A Review

2018 ◽  
Vol 8 (11) ◽  
pp. 202 ◽  
Author(s):  
Maria Pino ◽  
Alessia Imperato ◽  
Irene Musca ◽  
Rosario Maugeri ◽  
Giuseppe Giammalva ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Brain Tumors ◽  
Low Cost ◽  
Tumor Resection ◽  
Intraoperative Ultrasound ◽  
Tumor Surgery ◽  
Brain Tumor Surgery ◽  
Glioma Surgery ◽  
Pubmed Database

Maximal safe resection represents the gold standard for surgery of malignant brain tumors. As regards gross-total resection, accurate localization and precise delineation of the tumor margins are required. Intraoperative diagnostic imaging (Intra-Operative Magnetic Resonance-IOMR, Intra-Operative Computed Tomography-IOCT, Intra-Operative Ultrasound-IOUS) and dyes (fluorescence) have become relevant in brain tumor surgery, allowing for a more radical and safer tumor resection. IOUS guidance for brain tumor surgery is accurate in distinguishing tumor from normal parenchyma, and it allows a real-time intraoperative visualization. We aim to evaluate the role of IOUS in gliomas surgery and to outline specific strategies to maximize its efficacy. We performed a literature research through the Pubmed database by selecting each article which was focused on the use of IOUS in brain tumor surgery, and in particular in glioma surgery, published in the last 15 years (from 2003 to 2018). We selected 39 papers concerning the use of IOUS in brain tumor surgery, including gliomas. IOUS exerts a notable attraction due to its low cost, minimal interruption of the operational flow, and lack of radiation exposure. Our literature review shows that increasing the use of ultrasound in brain tumors allows more radical resections, thus giving rise to increases in survival.

Role of Perioperative Factor XIII in Intracerebral Hemorrhage after Brain Tumor Surgery: A Prospective Study

2019 ◽  
Author(s):  
Estela Val Jordan ◽  
Agustín Nebra Puertas ◽  
Juan Casado Pellejero ◽  
Maria Dolores Vicente Gordo ◽  
Concepción Revilla López ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Intracerebral Hemorrhage ◽  
Prospective Study ◽  
Factor Xiii ◽  
Tumor Surgery ◽  
Brain Tumor Surgery ◽  
A Prospective Study

scholarly journals Postoperative Hypoalbuminemia: Prevalence, Risk Factors, Association with Postoperative Pneumonia in Brain Tumors Patients Undergoing Craniotomy

2021 ◽  
Author(s):  
Da-wei Zhao ◽  
Xu-yang Zhang ◽  
Kai-yan Wei ◽  
Yi-bin Jiang ◽  
Dan Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Brain Tumor ◽  
Brain Tumors ◽  
Operation Time ◽  
Postoperative Pneumonia ◽  
Tumor Surgery ◽  
Regression Analyses ◽  
Brain Tumor Surgery ◽  
The Impact ◽  
Preoperative Albumin

Abstract Hypoalbuminemia is associatied with poor outcome in patients undergoing surgery intervention. The main aim for this study was to investigate the incidence and the risk factors of postoperative hypoalbuminemia and assessed the impact of postoperative hypoalbuminemia on complications in patients undergoing brain tumor surgery. This retrospective study included 372 consecutive patients who underwent brain tumors surgery from January 2017 to December 2019. The patients were divided into hypoalbuminemia (< 35 g/L) and non-hypoalbuminemia group (≥ 35 g/L) based on postoperative albumin levels. Logistic regression analyses were used to determine risk factors. Of the total 372 patients, 333 (89.5%) developed hypoalbuminemia after surgery. Hypoalbuminemia was associated with operation time (OR 1.011, P < 0.001), preoperative albumin (OR 0.864, P = 0.015) and peroperative globulin (OR 1.192, P = 0.004). Postoperative pneumonia had a higher incidence in patients with than without hypoalbuminemia (41.1% vs 23.1%, P = 0.029). The independent predictors of postoperative pneumonia were age (OR 1.053, P < 0.001), operation time (OR 1.003, P = 0.013) and lower postoperative albumin (OR 0.946, P = 0.018). Postoperative hypoalbuminemia has a higher incidence with the increase of operation time, and is associated with postoperative pneumonia in patients undergoing brain tumor surgery.

scholarly journals An intraoperative motor tract positioning method in brain tumor surgery: technical note

2018 ◽  
Vol 129 (3) ◽  
pp. 576-582 ◽  
Author(s):  
Fumio Yamaguchi ◽  
Hirotomo Ten ◽  
Tadashi Higuchi ◽  
Tomoko Omura ◽  
Toyoyuki Kojima ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Brain Mapping ◽  
Motor Evoked Potentials ◽  
Tumor Resection ◽  
Safety Margin ◽  
Mapping Method ◽  
Tumor Surgery ◽  
Brain Tumor Surgery ◽  
Positioning Method ◽  
Motor Tracts

Intraoperative 3D recognition of the motor tract is indispensable to avoiding neural fiber injury in brain tumor surgery. However, precise localization of the tracts is sometimes difficult with conventional mapping methods. Thus, the authors developed a novel brain mapping method that enables the 3D recognition of the motor tract for intrinsic brain tumor surgeries. This technique was performed in 40 consecutive patients with gliomas adjacent to motor tracts that have a risk of intraoperative pyramidal tract damage. Motor tracts were electrically stimulated and identified by a handheld brain-mapping probe, the NY Tract Finder (NYTF). Sixteen-gauge plastic tubes were mounted onto the NYTF and inserted in the estimated direction of the motor tract with reference to navigational information. Only the NYTF was removed, leaving the plastic tubes in their places, immediately after muscle motor evoked potentials were recorded at the minimum stimulation current. Motor tracts were electrically identified in all cases. Three-dimensional information on the position of motor tracts was given by plastic tubes that were neurophysiologically placed. Tips of tubes showed the resection limit during tumor removal. Safe tumor resection with an arbitrary safety margin can be performed by adjusting the length of the plastic tubes. The motor tract positioning method enabled the 3D recognition of the motor tract by surgeons and provided for safe resection of tumors. Tumor resections were performed safely before damaging motor tracts, without any postoperative neurological deterioration.

The role of diffusion tensor imaging in brain tumor surgery: A review of the literature

2014 ◽  
Vol 124 ◽  
pp. 51-58 ◽  
Author(s):  
Adriaan R.E. Potgieser ◽  
Michiel Wagemakers ◽  
Arjen L.J. van Hulzen ◽  
Bauke M. de Jong ◽  
Eelco W. Hoving ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Diffusion Tensor Imaging ◽  
Diffusion Tensor ◽  
Tumor Surgery ◽  
Review Of The Literature ◽  
Brain Tumor Surgery

387 Ischemic Preconditioning Reduces the Incidence of Postoperative Ischemic Lesions in Patients Undergoing Surgical Resection of Brain Tumors: A Single Center, Randomized, Double-blind, Controlled Trial

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 292-293
Author(s):  
Arthur H A Sales ◽  
Melanie Barz ◽  
Stefanie Bette ◽  
Benedikt Wiestler ◽  
Yu-Mi Ryang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Brain Tumor ◽  
Brain Tumors ◽  
Ischemic Preconditioning ◽  
Control Group ◽  
Tumor Surgery ◽  
Brain Tumor Surgery ◽  
Blood Pressure Cuff ◽  
Pressure Cuff ◽  
Ischemic Tissue

Abstract INTRODUCTION Postoperative ischemia is a frequent phenomenon in patients with brain tumors and is associated with postoperative neurological deficits and impaired overall survival. Previous clinical and experimental studies have shown that the application of a brief ischemic stimulus not only in the target organ but also in a remote tissue can prevent ischemia. We hypothesized that remote ischemic preconditioning (rIPC) in patients with brain tumors undergoing elective surgical resection reduces the incidence of postoperative ischemic tissue damage and its consequences. METHODS Sixty patients were randomly assigned to two groups, with 1:1 allocation, stratified after tumor type (glioma or metastasis) and previous treatment with radiotherapy. Remote ischemic preconditioning was induced by inflating a blood pressure cuff placed on the upper arm three times for 5 minutes at 200 mmHg in the treatment group after induction of anesthesia. Between the cycles, the blood pressure cuff was released to allow reperfusion. In the control group no preconditioning was performed. Early postoperative MR images were evaluated blinded to randomization for the presence of ischemia and its volume. RESULTS >Fifty-eight of the 60 patients were assessed for occurrence of postoperative ischemia. Of these 58 patients, 44 (75.9%) had new postoperative ischemic lesions. The incidence of new postoperative ischemic lesions was significantly higher in the control group (87.1%) (27/31) than in the rIPC group (63.0%) (17/27) (P = 0.03). The median infarct volume was 0.36 cm3 (IR: 0.0- 2.35) in the rIPC group compared with 1.30 cm3 (IR: 0.29- 3.66) in the control group (P = 0.09). CONCLUSION Application of rIPC significantly reduced the incidence of postoperative ischemic tissue damage in patients undergoing elective brain tumor surgery. This is the first study indicating a benefit of rIPC in brain tumor surgery.

scholarly journals Basic Principles of Intraoperative Ultrasound Applied to Brain Tumor Surgery

2020 ◽  
Vol 9 (02) ◽  
pp. 135-140
Author(s):  
Javier A. Jacobo ◽  
Javier Avendaño ◽  
Sergio Moreno-Jimenez ◽  
Santiago Nuñez ◽  
Rocio Mamani
Keyword(s):  
Brain Tumor ◽  
Tumor Volume ◽  
Intraoperative Ultrasound ◽  
Extent Of Resection ◽  
Basic Knowledge ◽  
Full Potential ◽  
Tumor Surgery ◽  
Brain Tumor Surgery ◽  
Basic Principles ◽  
Metastatic Lesions

AbstractIntraoperative ultrasound (US) has been shown to possess great value in assessing tumor volume and localization, especially for primary resection of gliomas and metastatic lesions. Given that US is a technology that is highly user dependent, many surgeons have encountered problems with the usage of this technology, as well as interpretation of intraoperative US images, limiting its full potential. This article focuses on the basic knowledge a neurosurgeon must acquire to properly use and interpret intraoperative US to improve tumor localization and extent of resection during brain tumor surgery.

scholarly journals Safety and Costs Analysis of a Fast-track Algorithm for Early Hospital Discharge After Brain Tumor Surgery

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Danilo Gomes Quadros ◽  
Iuri S Neville ◽  
Francisco M Urena ◽  
Davi J Fontoura Solla ◽  
Wellingson S Paiva ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Hospital Discharge ◽  
Readmission Rate ◽  
Fast Track ◽  
Tumor Resection ◽  
Hospital Costs ◽  
Tumor Surgery ◽  
Brain Tumor Surgery ◽  
Hospitalization Costs ◽  
Brain Tumor Resection

Abstract INTRODUCTION Until the 1990 s, perioperative care was based on empirical concepts and common practice, in part due to the paucity of scientific evidence. With the need of improving patient outcomes and reducing costs, the concern of developing safe and effective standards in postoperative care emerged. Recently, our institution has adopted a daily algorithm for hospital discharge (DAHD), which is a key point in the concept of Fast-Track Surgery. Thus, we designed a study to evaluate whether there was a difference in length of stay (LOS), rate of complications, and hospital costs after the introduction of the DAHD in the postoperative management of patients who underwent brain tumor resection. METHODS This is a retrospective cohort study. All consecutive patients who underwent brain tumor resection in 2017 by a single neurosurgeon were analyzed. Demographic and procedure-related variables, clinical outcomes, and healthcare costs within 30 d after surgery were collected and compared in patients before (preimplementation) and after (postimplementation) the daily algorithm for hospital discharge (DAHD). RESULTS About 61 patients who had been submitted to brain tumor resection were studied (preimplementation 32, postimplementation 29). The baseline demographic characteristics were similar between the groups. After the DAHD implementation, LOS after surgery in days decreased significantly (median 5 vs 3 days; P = .001). The proportion of patients who were discharged within day 1 or 2 after surgery was significantly higher after DAHD protocol (3.1% vs 44.8%; P < .001). Major and minor complications rates, readmission rate, and unplanned return to hospital in 30-day follow-up were comparable between the groups. There was a significant reduction in the median costs of hospitalization in DAHD group (US$2135 vs US$2765, P = .043), mainly due to a reduction in median ward costs (US$922 vs US$1623, P = .009). CONCLUSION Early discharge after brain tumor surgery was safe, inexpensive, reduced the LOS, and hospitalization costs without increase in readmission rate or postoperative complications.

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