de Laurentis, Camilla and Hoehne, Julius and Cavallo, Claudio and Restelli, Francesco and Falco, Jacopo and Broggi, Morgan and Bosio, Lorenzo and Vetrano, Ignazio G. and Schiariti, Marco and Zattra, Costanza M. and Ferroli, Paolo and Schebesch, Karl-Michael and Acerbi, Francesco (2019) The impact of fluorescein-guided technique in the surgical removal of CNS tumors in a pediatric population: results from a multicentric observational study. JOURNAL OF NEUROSURGICAL SCIENCES, 63 (6). pp. 679-687. ISSN 0390-5616, 1827-1855
Full text not available from this repository. (Request a copy)Abstract
BACKGROUND: Surgery has a fundamental role in central nervous system (CNS) tumors in the pediatric population, as aggressive resection correlates with prognosis. Due to its accumulation in areas with damaged blood brain barrier, sodium fluorescein (SF) could be a valid tool to improve the extent of resection in tumors enhancing at preoperative MRI. This study is aimed to systematically assess the utility of SF in a pediatric population. METHODS: Patient data were collected in two centers, one in Italy and the other in Germany. At the induction of anesthesia, SF was administered intravenously (5 mg/kg). Surgery was performed using a YELLOW560 filter. Fluorescence intensity was graduated as bright, moderate or absent based on surgeon's opinion; furthermore, SF use was judged as "helpful." "not helpful" or "not essential" in tumor removal. RESULTS: Twenty-four patients for 27 surgical procedures were identified. In 21 of 27 (77.8%) procedures fluorescence was reported as bright or moderate, in two of 27 (7.4%) absent and in four of 27 (14.8%) data were unavailable. Intraoperative fluorescence was reported in 21 of 25 (84%) surgeries whose corresponding preoperative MRI had shown contrast enhancement. In 14 of 27 (51.8%) surgical procedures SF was considered "helpful"; in two of 27 (7.4%) not "helpful"; in seven of 27 (25.9%) "not essential." In four of 27 (14.8%) data were unavailable. No adverse effect to SF was registered. CONCLUSIONS: SF could be considered a valid and safe tool to improve visualization of tumors enhancing at preoperative MRI also in pediatric patients. Future prospective studies are needed to confirm these preliminary' data.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | HIGH-GRADE GLIOMAS; 5-AMINOLEVULINIC ACID; BRAIN-TUMORS; INTRAOPERATIVE ULTRASOUND; ISCHEMIC-STROKE; RESECTION; SURGERY; CHILDREN; SODIUM; MEDULLOBLASTOMA; Fluorescein; Neurosurgery; Pediatrics; Video-assisted surgery |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Neurochirurgie Medicine > Abteilung für Neuropathologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 20 Mar 2020 11:11 |
| Last Modified: | 20 Mar 2020 11:11 |
| URI: | https://pred.uni-regensburg.de/id/eprint/25713 |
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