Sulangi Albert Joseph, Husain Adam, Lei Haoyi, Okun Jessica
Nova Southeastern University, Dr. Kiran C. Patel College of Osteopathic Medicine-Tampa Bay Regional Campus, Clearwater, FL, United States.
University of Texas Medical Branch, Galveston, TX, United States.
Front Surg. 2024 Aug 6;11:1430567. doi: 10.3389/fsurg.2024.1430567. eCollection 2024.
Glioma resection aims for maximal tumor removal while preserving neurological function. Neuronavigation systems (NS), with intraoperative imaging, have revolutionized this process through precise tumor localization and detailed anatomical navigation.
To assess the efficacy and breadth of neuronavigation and intraoperative imaging in glioma resections, identify operational challenges, and provide educational insights to medical students and non-neurosurgeons regarding their practical applications.
This systematic review analyzed studies from 2012 to 2023 on glioma patients undergoing surgical resection with neuronavigation, sourced from MEDLINE (PubMed), Embase, and Web of Science. A database-specific search strategy was employed, with independent reviewers screening for eligibility using Rayyan and extracting data using the Joanna Briggs Institute (JBI) tool.
The integration of neuronavigation systems with intraoperative imaging modalities such as iMRI, iUS, and 5-ALA significantly enhances gross total resection (GTR) rates and extent of resection (EOR). While advanced technology improves surgical outcomes, it does not universally reduce operative times, and its impact on long-term survival varies. Combinations like NS + iMRI and NS + 5-ALA + iMRI achieve higher GTR rates compared to NS alone, indicating that advanced imaging adjuncts enhance tumor resection accuracy and success. The results underscore the multifaceted nature of successful surgical outcomes.
Integrating intraoperative imaging with neuronavigation improves glioma resection. Ongoing research is vital to refine technology, enhance accuracy, reduce costs, and improve training, considering various factors impacting patient survival.
胶质瘤切除术旨在在保留神经功能的同时最大程度地切除肿瘤。带有术中成像的神经导航系统通过精确的肿瘤定位和详细的解剖导航彻底改变了这一过程。
评估神经导航和术中成像在胶质瘤切除术中的疗效和广度，识别操作挑战，并就其实际应用向医学生和非神经外科医生提供教育见解。
本系统评价分析了2012年至2023年关于接受神经导航手术切除的胶质瘤患者的研究，这些研究来自MEDLINE（PubMed）、Embase和科学网。采用特定数据库的搜索策略，由独立评审员使用Rayyan筛选纳入标准，并使用乔安娜·布里格斯研究所（JBI）工具提取数据。
神经导航系统与术中成像模式（如术中磁共振成像（iMRI）、术中超声（iUS）和5-氨基乙酰丙酸（5-ALA））的整合显著提高了全切除率（GTR）和切除范围（EOR）。虽然先进技术改善了手术结果，但并非普遍缩短手术时间，其对长期生存的影响也各不相同。与单独使用神经导航系统相比，神经导航系统+iMRI和神经导航系统+5-ALA+iMRI等组合实现了更高的全切除率，表明先进的成像辅助手段提高了肿瘤切除的准确性和成功率。结果强调了成功手术结果的多面性。
术中成像与神经导航相结合可改善胶质瘤切除术。考虑到影响患者生存的各种因素，持续研究对于改进技术、提高准确性、降低成本和改善培训至关重要。
