Carai Andrea, Mastronuzzi Angela, De Benedictis Alessandro, Messina Raffaella, Cacchione Antonella, Miele Evelina, Randi Franco, Esposito Giacomo, Trezza Andrea, Colafati Giovanna Stefania, Savioli Alessandra, Locatelli Franco, Marras Carlo Efisio
Neurosurgery Unit, Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Department of Hematology/Oncology and Stem Cell Transplantation, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
World Neurosurg. 2017 May;101:584-588. doi: 10.1016/j.wneu.2017.02.088. Epub 2017 Feb 27.
Diffuse intrinsic pontine glioma (DIPG) is a childhood tumor with a dismal prognosis. Emerging molecular signatures have paved the way for stereotactic biopsy in selected centers. We present our experience in DIPG stereotactic needle biopsy using the Robotic Stereotactic-Assisted system (ROSA) in a series of consecutive pediatric patients.
All stereotactic biopsy procedures for DIPG performed during the last year at our institution were considered. All procedures were carried out using the ROSA surgical assistant through a precoronary approach. All children underwent a postoperative computed tomography scan to document possible surgical complications and confirm the site of biopsy. Postoperative clinical changes were recorded to test morbidity of the procedure.
In the last year, we performed 7 pontine needle biopsies. Specimens were diagnostic and useful for molecular analysis in all cases. No surgical complications were observed. One child showed a transient neurologic worsening related to the biopsy that resolved within 2 weeks. The combination of the precoronary approach and use of the stereotactic ROSA system allowed single-session surgeries in all cases.
Pontine biopsy for DIPG is a safe procedure in selected centers. The advantages of the single-session procedure we described might be of particular interest in the pediatric setting.
弥漫性脑桥内在型胶质瘤（DIPG）是一种预后极差的儿童肿瘤。新出现的分子特征为特定中心开展立体定向活检铺平了道路。我们介绍了我们在一系列连续儿科患者中使用机器人立体定向辅助系统（ROSA）进行DIPG立体定向针吸活检的经验。
考虑了我们机构去年进行的所有DIPG立体定向活检手术。所有手术均通过冠状动脉前入路使用ROSA手术辅助设备进行。所有儿童术后均接受计算机断层扫描，以记录可能的手术并发症并确认活检部位。记录术后临床变化以检测该手术的发病率。
去年，我们进行了7次脑桥针吸活检。所有病例的标本均具有诊断价值且有助于分子分析。未观察到手术并发症。一名儿童出现与活检相关的短暂神经功能恶化，在2周内缓解。冠状动脉前入路与立体定向ROSA系统的联合使用使所有病例均能在单次手术中完成。
在特定中心，DIPG的脑桥活检是一种安全的手术。我们所描述的单次手术的优势在儿科环境中可能特别有意义。
