Alcocer-Barradas V, Sotomayor-González A, López-Serna R, Ponce-Gómez JA, Soriano H, Bargés-Coll J, Gómez-Amador JL

Language: Spanish
References: 8
Page: 22-26
PDF size: 856.31 Kb.

ABSTRACT

Primary tumors of the central nervous system are among the leading causes of cancer related deaths in the United States. Surgical resection of deep lesions represents a challenge for neurosurgeons. Advances in navigation systems, the introduction of endoscopy and endoscopic port allows removal of deep lesions with minimally invasive approaches. Materials and methods: we performed an observational, descriptive case series. We included 19 patients in the neurosurgery service at the National Institute of Neurology and Neurosurgery diagnosed with deep brain lesions. Results: Twelve patients were female, mean age 38 ± 17 years, the most frequent location was frontal in 12 cases (63%). The average depth was 28mm. The more common histopathologic diagnosis were glioma in 6 (31%) cases and cavernoma in 2 (10%) cases. Total resection was achieved in 12 (63%) cases. Conclusion: resection of deep brain tumors through the single endoscopic port is technically feasible. Primary and metastatic lesions can be resected with this technique with minimally invasive approaches, smaller craniotomies and less dissection of white matter, which results in less postoperative morbidity.

REFERENCES

1. ACS (American Cancer Society): Cancer facts and figures. Atlanta. Am Cancer Society 2002.

2. Rosenorn J , Diemer NH . Reduction of regional cerebral blood flow during brain retraction pressure in the rat. J Neurosurg 1982; 5 6: 8 26-8 29.

3. Zhong J, Dujovny M, Perlin AR. Brain retraction injury. Neurol Res 2003; 25 : 831-8.

4. Raza SM. Minimally Invasive trans-portal resection. Minimal Invasive Neurosurgery 2011; 54: 5-11.

5. Kassam Amin B, Engh Johnathan A, Mintz Arlan H, Prevedello Daniel M. Completely endoscopic resection of intraparenchymal brain tumors. J Neurosurg 2009;110:116-23.

6. Jacques S, Shelden CH, McCann GD, Freshwater DB, Rand R. Computerized three-dimensional stereotaxic removal of small central nervous system lesions in patients. J Neurosurg 1980;53:816-20.

7. Shelden CH, McCann G, Jacques S, Lutes HR, Frazier RE, Katz R, et al. Development of a computerized microstereotaxic method for localization and removal of minute CNS lesions under direct 3-D vision: technical report. J Neurosurg 1980;52:21-7.

8. Otsuki T, Jokura H, Yoshimoto T. Stereotactic guiding tube for open system endoscopy: a new approach for the stereotactic endoscopy resection of intra-axial brain tumors. Neurosurgery 1990;27: 326-30.