Takada Shigeki, Hattori Etsuko Yamamoto, Sano Noritaka, Sawada Masahiro, Tanji Masahiro, Mineharu Yohei, Kikuchi Takayuki, Arakawa Yoshiki
Department of Neurosurgery, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
Regulatory Science of Medical Device Development and Innovation, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
Sci Rep. 2025 May 23;15(1):17953. doi: 10.1038/s41598-025-03219-w.
To accomplish maximal safe resection for insular glioma (IG), we perform awake surgery (AS) for IG. The aim of our study was to identify potential predictors of AS failure for IG. We retrospectively reviewed the records of 24 patients with IGs who underwent resection between January 2014 and April 2024. Their baseline characteristics and clinical outcomes were examined and we analysed the factors associated with AS failure. AS was planned and performed successfully in 13 cases (the AS group). In five cases, AS was planned but failed due to sleepiness or delayed awakening. AS was not planned in six cases. These 11 cases were assigned to the non-AS (NAS) group. The median extent of tumor resection was 87.7% in the AS group vs. 58.0% in the NAS group (p = 0.004). There were no cases with postoperative permanent neurological deficits in both groups. Basal ganglionic involvement, which means the high-intensity area on Fluid Attenuated Inversion Recovery imaging is found in the basal ganglia consisting of the striatum and globus pallidus, was significantly associated with AS failure. AS contributes significantly to the maximal resection of IG. Basal ganglionic involvement is a potential predictor of AS failure for IG.
为实现岛叶胶质瘤（IG）的最大安全切除，我们对IG患者进行清醒手术（AS）。本研究的目的是确定IG患者AS失败的潜在预测因素。我们回顾性分析了2014年1月至2024年4月期间接受手术切除的24例IG患者的记录。检查了他们的基线特征和临床结果，并分析了与AS失败相关的因素。13例患者成功计划并实施了AS（AS组）。5例患者计划实施AS，但因嗜睡或苏醒延迟而失败。6例患者未计划实施AS。这11例患者被归入非AS（NAS）组。AS组的肿瘤切除中位范围为87.7%，而NAS组为58.0%（p = 0.004）。两组均无术后永久性神经功能缺损病例。基底节受累，即在液体衰减反转恢复成像上发现高强度区域位于由纹状体和苍白球组成的基底节，与AS失败显著相关。AS对IG的最大切除有显著贡献。基底节受累是IG患者AS失败的潜在预测因素。
