Andrej Šteňo1, Vladimír Hollý2, Peter Mendel2, Veronika Šteňová3, Ľubica Petričková4, Gabriela Timárová5, Michaela Jezberová6, Víťazoslav Belan6, Boris Rychlý7,8, Jozef Šurkala4, Juraj Šteňo4. 1. Department of Neurosurgery, Comenius University, Faculty of Medicine, University Hospital Bratislava, Limbová 5, 833 05, Bratislava, Slovakia. andrej.steno@gmail.com. 2. Department of Anaesthesiology, Slovak Medical University, University Hospital Bratislava, Bratislava, Slovakia. 3. Speech and language therapy clinic, University Hospital Bratislava, Bratislava, Slovakia. 4. Department of Neurosurgery, Comenius University, Faculty of Medicine, University Hospital Bratislava, Limbová 5, 833 05, Bratislava, Slovakia. 5. II. Department of Neurology, Comenius University, Faculty of Medicine, University Hospital Bratislava, Bratislava, Slovakia. 6. Dr. Magnet s.r.o, Bratislava, Slovakia. 7. Department of Pathology, Slovak Medical University, Bratislava, Slovakia. 8. Cytopathos s.r.o, Bratislava, Slovakia.
Abstract
BACKGROUND: The data showing usefulness of navigated 3D-ultrasound (3DUS) during awake resections of eloquent gliomas are sparse. Results of surgeries performed using 3DUS were never compared to procedures guided by standard neuronavigation. The aim of this work is to assess the effectiveness of 3DUS during awake resections of eloquent low-grade gliomas (LGGs) by comparing surgical results of two series of patients operated on using conventional neuronavigation and using 3DUS. To our knowledge, a similar study is lacking in the literature. METHODS: During a 4-year period (September 2006 to August 2010) 21 awake resections of LGGs guided by neuronavigation (series 1, S1) were consecutively performed in Department of Neurosurgery in Bratislava. During another 4-year period (August 2010 to July 2014) 28 awake resections of LGGs guided by 3DUS (series 2, S2) were consecutively conducted. In both patients series, the eloquent cortical and subcortical structures were intraoperatively detected by direct electrical stimulation. Extent of tumor resection (EOR) and functional outcome in both series were compared. RESULTS: EOR was significantly greater (p = 0.022) in S2 (median = 93.25%; mean = 86.79%), as compared to S1 (median 87.1%; mean = 75.85%). One permanent minor deficit in S1 and 2 minor deficits in S2 occurred, the difference was not significant (p = 0.999). CONCLUSIONS: Our work represents the first study comparing results of surgeries guided by 3DUS versus conventional navigation. The extent of awake resections of eloquent LGG guided by 3DUS was greater comparing to awake resections guided by standard neuronavigation; use of 3DUS had no impact on the number of new permanent deficits.
BACKGROUND: The data showing usefulness of navigated 3D-ultrasound (3DUS) during awake resections of eloquent gliomas are sparse. Results of surgeries performed using 3DUS were never compared to procedures guided by standard neuronavigation. The aim of this work is to assess the effectiveness of 3DUS during awake resections of eloquent low-grade gliomas (LGGs) by comparing surgical results of two series of patients operated on using conventional neuronavigation and using 3DUS. To our knowledge, a similar study is lacking in the literature. METHODS: During a 4-year period (September 2006 to August 2010) 21 awake resections of LGGs guided by neuronavigation (series 1, S1) were consecutively performed in Department of Neurosurgery in Bratislava. During another 4-year period (August 2010 to July 2014) 28 awake resections of LGGs guided by 3DUS (series 2, S2) were consecutively conducted. In both patients series, the eloquent cortical and subcortical structures were intraoperatively detected by direct electrical stimulation. Extent of tumor resection (EOR) and functional outcome in both series were compared. RESULTS: EOR was significantly greater (p = 0.022) in S2 (median = 93.25%; mean = 86.79%), as compared to S1 (median 87.1%; mean = 75.85%). One permanent minor deficit in S1 and 2 minor deficits in S2 occurred, the difference was not significant (p = 0.999). CONCLUSIONS: Our work represents the first study comparing results of surgeries guided by 3DUS versus conventional navigation. The extent of awake resections of eloquent LGG guided by 3DUS was greater comparing to awake resections guided by standard neuronavigation; use of 3DUS had no impact on the number of new permanent deficits.
Authors: Andrej Šteňo; Ján Buvala; Veronika Babková; Adrián Kiss; David Toma; Alexander Lysak Journal: Front Oncol Date: 2021-03-22 Impact factor: 6.244