Nguyen Phuong Xuan, Thi-Ngoc Doan Ha, Van Vu Hoe
Department of Neurosurgery, Military Hospital 103, Hanoi, 12108, Viet Nam.
Bach Mai Hospital, Hanoi, 100000, Viet Nam.
Ann Med Surg (Lond). 2022 Nov 21;84:104905. doi: 10.1016/j.amsu.2022.104905. eCollection 2022 Dec.
Neuronavigation has been applied in neurocenters to help neurosurgeons plan the way to resect tumor totally and decline the neuro-injuries. This study aims to initially evaluate the result of microsurgery applying neuronavigation in treating falcine meningioma, which has not been reported comprehensively in Vietnam.
This cross-sectional study enrolled 62 patients diagnosised with falcine meningioma and treated by applying neuronavigation in operation in Neurosurgery Department of Military Hospital 103 and Viet Duc University Hospital from July 2015 to March 2017. Patients were assessed complications as well as residual lesions. Evaluate surgical results when discharging from hospital according to Ojemann MD standard.
Mean tumor volume was 67.37 ± 66.61 cm³ (range 6-370 cm³). Unilateral access site was the most common with 85.48%. Mean surgery duration was 209.84 ± 70.86 min. There were 27 out of 62 patients (43.55%) need blood transfusion in surgery. Tumor volume had an impact on blood transfusion in operation with p = 0.002. 82.26% of patients had total resection (Simpson I,II). There were 4.84% of patients having haemorrhage and 3 patients (4.84%) had wound infection after operation. Short-term outcome was evaluated according to Ojemann MD standard: good outcome was 67.74%, medium 17.74%, and poor outcome 14.52%.
The application of neuronavigation and microsurgery enables surgeons to access falcine meningiomasare exactly, lessen the surgery duration, limit blood transfusion and complications after operation.
神经导航已在神经中心得到应用,以帮助神经外科医生规划肿瘤全切路径并减少神经损伤。本研究旨在初步评估应用神经导航的显微手术治疗矢状窦旁脑膜瘤的效果,在越南尚未有全面报道。
本横断面研究纳入了2015年7月至2017年3月在103军事医院神经外科和越德大学医院接受神经导航手术治疗的62例矢状窦旁脑膜瘤患者。评估患者的并发症及残留病变情况。根据奥杰曼医学博士标准评估出院时的手术效果。
肿瘤平均体积为67.37±66.61cm³(范围6 - 370cm³)。单侧入路部位最为常见,占85.48%。平均手术时长为209.84±70.86分钟。62例患者中有27例(43.55%)在手术中需要输血。肿瘤体积对术中输血有影响,p = 0.002。82.26%的患者实现全切(辛普森I、II级)。术后有4.84%的患者发生出血,3例(4.84%)发生伤口感染。根据奥杰曼医学博士标准评估短期预后:良好预后为67.74%,中等为17.74%,差为14.52%。
神经导航和显微手术的应用使外科医生能够精确到达矢状窦旁脑膜瘤,缩短手术时长,减少术中输血及术后并发症。