Microscopic Resection of Intracranial Lesions with Tubular Retractor of Plastic Syringe: A Single-Center Experience of 157 Cases.

Objective: Deeply located intracranial lesions such as intraparenchymal and intraventricular lesions are surgically challenging and associated with unavoidable complications such as seizure, surgical bed hematoma, and brain contusion caused by traction. The objective of this study is to evaluate the safety and effectiveness of the microscopic tubular retractor of a plastic syringe for the resection of deeply located brain lesions.

Materials and methods: We retrospectively studied 157 patients with deep-seated intracranial lesions who underwent microscopic resection with the help of a tubular retractor made of a plastic syringe and Teflon introducer between January 2018 and January 2024 in a tertiary hospital. All deep-seated lesions were such as neurocytoma, lymphoma, ependymoma, colloid cysts, metastatic brain tumors, astrocytoma, and meningiomas. We evaluated all patients postoperatively with computed tomography (CT) scan on the first/second day of surgery. The amount of blood loss, the complications, and the mortality rate were recorded.

Results: There were 104 males and 53 females with a mean age of 54.13 (range: 15-80) years. Gross total resection was obtained in 85.35% and subtotal in 14.65% of patients. Complications such as surgical bed hematoma in 5.73%, seizure in 3.18%, weakness in 2.54%, and contusion in 3.82% of patients were noted. The blood loss varied from 30 to 500 mL (average, 100 mL). The mortality rate was observed in 2.54% of all patients. Follow-up ranged from 1 to 25 months (average, 10 months).

Conclusion: Plastic syringe tubular retractor with Teflon introducer system is safe and effective for the treatment of deeply located intracranial lesions in terms of low morbidity and excellent rate of resection.