Ljungqvist Johan, Barchéus Hanna, Abbas Fatima, Ozanne Anneli, Nilsson Daniel, Corell Alba
Institute of Neuroscience and Physiology, Department of Clinical Neuroscience, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden.
Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
Neurooncol Adv. 2024 May 14;6(1):vdae079. doi: 10.1093/noajnl/vdae079. eCollection 2024 Jan-Dec.
Biopsies of intracranial lesions are a cornerstone in the diagnosis of unresectable tumors to guide neurooncological treatment; however, the procedure is also associated with risks. The results from the cranial robot guidance system Stealth Autoguide™ were studied after introduction at a neurosurgical department. Primary aims include the presentation of clinical and radiological data, accuracy of radiological diagnosis, learning curves of the new technology, diagnostic yield, and precision. The secondary aim was to study complications.
Retrospective data inclusion was performed on patients ≥ 18 years undergoing biopsy with Stealth Autoguide™ due to suspected brain tumors in the first 3 years after the introduction of the technique. Data regarding clinical characteristics, intraoperative variables, pathological diagnosis, and complications were recorded. Analyses of learning curves were performed.
A total of 79 procedures were performed on 78 patients with a mean age of 62 years (SD 12.7, range 23-82), 30.8% were female. Tumors were often multifocal (63.3%) and supratentorial (89.9%). The diagnostic yield was 87.3%. The first-hand radiological diagnosis was correct in 62.0%. A slight decrease in operation time was observed, although not significant. The surgeon contributed to 12% of the variability.
Robot-assisted biopsies with Stealth Autoguide™ seem to be comparable, with regards to complications, to frame-based and other frameless neurosurgical biopsies. Learning curves demonstrated no statistical differences in time of surgery and only 12% surgeon-related variation (ie, variation caused by the change of performing surgeon), suggesting a successful implementation of this technical adjunct.
颅内病变活检是不可切除肿瘤诊断的基石，可指导神经肿瘤治疗；然而，该操作也存在风险。在一个神经外科引入颅骨机器人引导系统Stealth Autoguide™后，对其结果进行了研究。主要目的包括展示临床和放射学数据、放射学诊断的准确性、新技术的学习曲线、诊断率和精确性。次要目的是研究并发症。
对该技术引入后的前3年中因疑似脑肿瘤而使用Stealth Autoguide™进行活检的≥18岁患者进行回顾性数据纳入。记录有关临床特征、术中变量、病理诊断和并发症的数据。进行学习曲线分析。
共对78例患者进行了79次操作，患者平均年龄62岁（标准差12.7，范围23 - 82岁），女性占30.8%。肿瘤常为多灶性（63.3%）且位于幕上（89.9%）。诊断率为87.3%。初次放射学诊断正确的占62.0%。观察到手术时间略有缩短，尽管不显著。外科医生造成的变异性为12%。
就并发症而言，使用Stealth Autoguide™进行机器人辅助活检似乎与基于框架和其他无框架神经外科活检相当。学习曲线显示手术时间无统计学差异，且外科医生相关的变异性仅为12%（即由执行手术的外科医生更换引起的变异性），表明该技术辅助手段成功实施。
