Göker Burcu, Kırış Talat
Department of Neurosurgery, Liv Hospital Ulus, Istanbul, Turkey.
Department of Neurosurgery, Istinye University Medical Faculty, Istanbul, Turkey.
Childs Nerv Syst. 2019 Mar;35(3):429-435. doi: 10.1007/s00381-018-04037-4. Epub 2019 Jan 4.
To evaluate the feasibility and safety of sodium fluorescein (Na-Fl)-guided surgery with the use of the PENTERO 900 surgical microscope (Carl Zeiss, Meditec, Oberkochen, Germany) equipped with the YELLOW-560-nm filter and low-dose Na-Fl (2 mg/kg) in pediatric brain tumor surgery.
The study included 23 pediatric patients with various intracranial pathologies, who underwent Na-Fl-guided surgery between April 2015 and February 2018. Clinical features, surgical observations, extent of resection, and tumor histopathology were retrospectively analyzed. The use of YELLOW-560-nm filter was found "helpful" if the discrimination of the pinkish brain tissue and bright yellow stained tumor tissue was clear. Otherwise, it was described as "not helpful."
There were 11 female and 12 male patients with a mean age of 9.4 years. There were 7 brain stem/tectal plate gliomas, 6 supratentorial tumors, 4 intraventricular tumors, 2 pineal tumors, 2 infratentorial tumors, 1 clivus tumor, and 1 tumor with supra- and infratentorial extensions in the current series. Na-Fl was found helpful by means of the tumor demarcation in 20 instances (87%). In 11 of these 20 operations (55%), a total resection was achieved regardless of the tumor pathology. A subtotal resection was achieved in the remaining 9 patients (45%). No adverse events or side effects were encountered with regard to Na-Fl use.
Na-Fl guidance with the use of the YELLOW-560 filter is safe and effective during brain tumor surgery in pediatric age group.
评估在小儿脑肿瘤手术中，使用配备560纳米黄色滤光片的PENTERO 900手术显微镜（德国奥伯科亨卡尔蔡司医疗技术公司）和低剂量荧光素钠（2毫克/千克）进行荧光素钠（Na-Fl）引导手术的可行性和安全性。
该研究纳入了23例患有各种颅内病变的儿科患者，他们于2015年4月至2018年2月期间接受了Na-Fl引导手术。对临床特征、手术观察结果、切除范围和肿瘤组织病理学进行了回顾性分析。如果粉红色脑组织和亮黄色染色的肿瘤组织之间的区分清晰，则使用560纳米黄色滤光片被认为“有帮助”。否则，将其描述为“无帮助”。
有11名女性和12名男性患者，平均年龄为9.4岁。在本系列中，有7例脑干/顶盖胶质瘤、6例幕上肿瘤、4例脑室内肿瘤、2例松果体肿瘤、2例幕下肿瘤、1例斜坡肿瘤和1例具有幕上和幕下延伸的肿瘤。在20例（87%）中，Na-Fl通过肿瘤边界划定被认为有帮助。在这20例手术中的11例（55%）中，无论肿瘤病理如何，均实现了全切。其余9例患者（45%）实现了次全切。在使用Na-Fl方面未遇到不良事件或副作用。
在小儿年龄组的脑肿瘤手术中，使用560纳米黄色滤光片的Na-Fl引导是安全有效的。
