Subpial en bloc resection improves extent of resection in infiltrating gliomas – A propensity matched comparative cohort analysis

Mishra, Arima; Janu, Amit; Trivedi, Kamaxi; Shetty, Prakash; Singh, Vikas; Moiyadi, Aliasgar

doi:10.1016/j.clineuro.2022.107197

Cited by 3 publications

(1 citation statement)

References 17 publications

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“…Resection was grouped into radical resection (EOR > 90%) and nonradical resection (EOR < 90%). Postoperative DWI was reviewed to check for significant postoperative ischemia, and the results were classified according to our previously reported schema [ 20 ]. Significant ischemia was classified as arterial or venous (thick peri-resection cavity DWI changes).…”

Section: Methodsmentioning

confidence: 99%

Factors affecting the extent of resection and neurological outcomes following transopercular resection of insular gliomas

Biswas,

Shetty,

Sahu

et al. 2024

Acta Neurochir

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Background Surgical resection of insular gliomas is a challenge. TO resection is considered more versatile and has lower risk of vascular damage. In this study, we aimed to understand the factors that affect resection rates, ischemic changes and neurological outcomes and studied the utility of IONM in patients who underwent TO resection for IGs. Methods Retrospective analysis of 66 patients with IG who underwent TO resection was performed. Results Radical resection was possible in 39% patients. Involvement of zone II and the absence of contrast enhancement predicted lower resection rate. Persistent deficit rate was 10.9%. Although dominant lobe tumors increased immediate deficit and fronto-orbital operculum involvement reduced prolonged deficit rate, no tumor related factor showed significant association with persistent deficits. 45% of patients developed a postoperative infarct, 53% of whom developed deficits. Most affected vascular territory was lenticulostriate (39%). MEP changes were observed in 9/57 patients. 67% of stable TcMEPs and 74.5% of stable strip MEPs did not develop any postoperative motor deficits. Long-term deficits were seen in 3 and 6% patients with stable TcMEP and strip MEPs respectively. In contrast, 25% and 50% of patients with reversible strip MEP and Tc MEP changes respectively had persistent motor deficits. DWI changes were clinically more relevant when accompanied by MEP changes intraoperatively, with persistent deficit rates three times greater when MEP changes occurred than when MEPs were stable. Conclusion Radical resection can be achieved in large, multizone IGs, with reasonable outcomes using TO approach and multimodal intraoperative strategy with IONM.

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Section: Methodsmentioning

confidence: 99%

Factors affecting the extent of resection and neurological outcomes following transopercular resection of insular gliomas

Biswas,

Shetty,

Sahu

et al. 2024

Acta Neurochir

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Preoperative assessment of eloquence in neurosurgery: a systematic review

Rammeloo,

Schouten,

Krikour

et al. 2023

J Neurooncol

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Advanced modalities and surgical theories in glioma resection

Guo

et al. 2022

Glioma

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Surgical resection is the core of the comprehensive treatment of glioma. However, with infiltrative growth features, glioma often invades the surrounding area, making surgical resection more difficult. This review introduces relevant topics presented at the World Federation of Neurosurgical Societie Foundation Asian Congress of Neurological Surgeons (ACNS) Minimally Invasive Neurosurgery Web Seminar in 2022. First, we review assistive surgical techniques' characteristics, advantages, and disadvantages. Second, we summarize some state-of-the-art surgical views in glioma resection. Advanced modalities and surgical theories in glioma resection make better “maximum safe resection” achievable.

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Subpial en bloc resection improves extent of resection in infiltrating gliomas – A propensity matched comparative cohort analysis

Cited by 3 publications

References 17 publications

Factors affecting the extent of resection and neurological outcomes following transopercular resection of insular gliomas

Factors affecting the extent of resection and neurological outcomes following transopercular resection of insular gliomas

Preoperative assessment of eloquence in neurosurgery: a systematic review

Advanced modalities and surgical theories in glioma resection

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