Zakariae Benyaich1, Farouk Hajhouji2, Mehdi Laghmari2, Houssine Ghannane2, Khalid Aniba2, Mohamed Lmejjati2, Said Ait Benali2. 1. Department of Neurosurgery, Mohamed the VIth University Hospital Center of Marrakech, Faculty of Medicine and Pharmacy of Marrakech, Cadi Ayyad University, Marrakech, Morocco. Electronic address: zakariae.benyaich@gmail.com. 2. Department of Neurosurgery, Mohamed the VIth University Hospital Center of Marrakech, Faculty of Medicine and Pharmacy of Marrakech, Cadi Ayyad University, Marrakech, Morocco.
Abstract
BACKGROUND: Awake craniotomy with brain mapping aims to maximize resection of gliomas located within eloquent regions while minimizing the risk of postoperative deficits. This technique is common practice in the developed world but has yet to be implemented in most low- and middle-income countries (LMICs). We assessed the feasibility, safety, and efficiency of functional-based glioma resection using minimal facilities in a limited-resource institution. METHODS: This is a retrospective review of patients harboring gliomas within eloquent regions who underwent awake craniotomy and tumor resection guided by cortico-subcortical mapping at a tertiary hospital of an LMIC. Patient characteristics, surgical results, and functional outcomes were studied. RESULTS: Twenty consecutive patients with a mean age of 37 years were enrolled in the study. Seizure, present in 70% of patients, was the major presenting symptom. Eighteen patients had diffuse low-grade gliomas and 2 patients had high-grade gliomas. Intraoperative events were dominated by seizures, occurring in 5 patients (25%). The average extent of tumor removal was 89.5% and the rate of total and subtotal removal was 85%. New postoperative deficits were observed in 5 patients (25%), and permanent deficits were found in 1 patient (5%). The main hurdles encountered were the difficulties in investigating patients and human resource availability. CONCLUSIONS: Awake craniotomy with brain mapping for functional-based resection of gliomas can be safely achieved in a limited-resource institution with good functional and oncologic results.
BACKGROUND: Awake craniotomy with brain mapping aims to maximize resection of gliomas located within eloquent regions while minimizing the risk of postoperative deficits. This technique is common practice in the developed world but has yet to be implemented in most low- and middle-income countries (LMICs). We assessed the feasibility, safety, and efficiency of functional-based glioma resection using minimal facilities in a limited-resource institution. METHODS: This is a retrospective review of patients harboring gliomas within eloquent regions who underwent awake craniotomy and tumor resection guided by cortico-subcortical mapping at a tertiary hospital of an LMIC. Patient characteristics, surgical results, and functional outcomes were studied. RESULTS: Twenty consecutive patients with a mean age of 37 years were enrolled in the study. Seizure, present in 70% of patients, was the major presenting symptom. Eighteen patients had diffuse low-grade gliomas and 2 patients had high-grade gliomas. Intraoperative events were dominated by seizures, occurring in 5 patients (25%). The average extent of tumor removal was 89.5% and the rate of total and subtotal removal was 85%. New postoperative deficits were observed in 5 patients (25%), and permanent deficits were found in 1 patient (5%). The main hurdles encountered were the difficulties in investigating patients and human resource availability. CONCLUSIONS: Awake craniotomy with brain mapping for functional-based resection of gliomas can be safely achieved in a limited-resource institution with good functional and oncologic results.
Authors: Ramin A Morshed; Jacob S Young; Andrew J Gogos; Alexander F Haddad; James T McMahon; Annette M Molinaro; Vivek Sudhakar; Nadeem Al-Adli; Shawn L Hervey-Jumper; Mitchel S Berger Journal: Acta Neurochir (Wien) Date: 2021-12-30 Impact factor: 2.216
Authors: Setthasorn Zhi Yang Ooi; Rosaline de Koning; Abdullah Egiz; David Ulrich Dalle; Moussa Denou; Marvin Richie Dongmo Tsopmene; Mehdi Khan; Régis Takoukam; Jay Kotecha; Dawin Sichimba; Yao Christian Hugues Dokponou; Ulrick Sidney Kanmounye; Nourou Dine Adeniran Bankole Journal: Int J Surg Protoc Date: 2022-02-02