Application of neuronavigation combined with yellow fluorescence staining in the resection of supratentorial glioma

Q4 Medicine

中华神经外科杂志 Pub Date : 2020-03-28 DOI:10.3760/CMA.J.CN112050-20190921-00406

Fugang Yang, Yu-hang Zhao, Wen-Hong Huang, Chao Yang, Chao Ma, Cheng-shi Xu

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Abstract

Objective To explore the application of neuronavigation combined with yellow fluorescence staining in the operation of glioma. Methods A retrospective study was conducted on the clinical data of 172 patients with supratentorial glioma who underwent surgical treatment at Department of Neurosurgery, Zhongnan Hospital of Wuhan University from January 2016 to March 2018. Among them, 55 cases were treated with neuronavigation combined with yellow fluorescence staining (navigation + fluorescence group) and 117 cases with conventional surgical techniques (control group). There were 81 patients with tumors involving the eloquent area, and neuroelectrophysiological monitoring and/or intraoperative awake anesthesia were applied in all those patients. Total resection rate was compared between the 2 groups to analyze the factors influencing the total resection rate. Results Total resection was performed in 58 patients confirmed by postoperative imaging. The total resection rate was 45.5%(25/55) in group of neuronavigation + fluorescence and 28.2%(33/117) in the control group. There was statistically significant difference between the 2 groups(P=0.026). Multiple logistic regression analysis revealed that involvement of eloquent area (OR=0.502, 95% CI: 0.253-0.998, P=0.049) and the technique of neuronavigation plus fluorescence (OR=2.173, 95% CI: 1.080-4.371, P=0.030) were independent prognostic factors of the total resection for glioma. Among the 81 patients involving the eloquent area, total resection was achieved in 21 patients(25.9%), of whom 13(61.9%) were treated with fluorescence combined with neuronavigation. Incomplete resection was achieved in 60 patients, of whom 16(26.7%) were treated with fluorescence combined with neuronavigation. There was statistically significant difference between the 2 groups (P=0.004). Multiple logistic regression analysis revealed that the technique of neuronavigation combined with fluorescence (OR=3.896, 95% CI: 1.331-11.405, P=0.013) were independent prognostic factors of total resection. Conclusion Neuronavigation combined with yellow fluorescence staining can be helpful in the total resection of glioma . Key words: Glioma; Neuronavigation; Fluorescence staining; Neurosurgical procedures; Extent of resection

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神经导航联合黄色荧光染色在幕上胶质瘤切除术中的应用

目的探讨神经导航结合黄色荧光染色在胶质瘤手术中的应用。方法对2016年1月至2018年3月在武汉大学中南医院神经外科接受手术治疗的172例幕上神经胶质瘤患者的临床资料进行回顾性研究。其中神经导航结合黄色荧光染色治疗55例（导航+荧光组），常规手术治疗117例（对照组）。有81名患者的肿瘤涉及雄辩区，所有这些患者都应用了神经电生理监测和/或术中清醒麻醉。比较两组患者的全切除率，分析影响全切除率的因素。结果58例经术后影像学检查证实的患者全部切除。神经导航+荧光组的总切除率为45.5%（25/55），对照组为28.2%（33/117）。两组间差异有统计学意义（P=0.026）。多元logistic回归分析显示，神经导航加荧光技术（OR=2.173，95%CI:1.080-4.371，P=0.030）和功能区受累（OR=0.502，95%CI:0.253-0.98，P=0.049）是神经胶质瘤全切除术的独立预后因素。在涉及雄辩区的81例患者中，21例（25.9%）患者实现了全切除，其中13例（61.9%）患者接受了荧光联合神经导航治疗。60例患者实现了不完全切除，其中16例（26.7%）接受了荧光联合神经导航治疗。两组间差异有统计学意义（P=0.004）。多元逻辑回归分析显示，神经导航技术结合荧光（OR=3.896，95%CI:1.331-11.405，P=0.013）是全切除术的独立预后因素。结论神经导航结合黄色荧光染色有助于胶质瘤的全切除。关键词：胶质瘤；神经导航；荧光染色；神经外科手术；切除范围

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来源期刊

中华神经外科杂志 Medicine-Surgery

CiteScore

0.10

自引率

0.00%

发文量

10706

期刊介绍： Chinese Journal of Neurosurgery is one of the series of journals organized by the Chinese Medical Association under the supervision of the China Association for Science and Technology. The journal is aimed at neurosurgeons and related researchers, and reports on the leading scientific research results and clinical experience in the field of neurosurgery, as well as the basic theoretical research closely related to neurosurgery.Chinese Journal of Neurosurgery has been included in many famous domestic search organizations, such as China Knowledge Resources Database, China Biomedical Journal Citation Database, Chinese Biomedical Journal Literature Database, China Science Citation Database, China Biomedical Literature Database, China Science and Technology Paper Citation Statistical Analysis Database, and China Science and Technology Journal Full Text Database, Wanfang Data Database of Medical Journals, etc.