Abstract:
The treatment for peripheral nerve sheath tumors (PNSTs) is based on surgical excision and the primary goal is to improve symptoms whilst preserving neurological function. In order to improve this technique, surgeons may use sodium fluorescein (SF) to help visualize the neoplasm and, consequently, facilitate its removal. Aiming to assess the efficacy of this emerging surgical strategy, we conducted a systematic review and single-arm meta-analysis. We conducted a systematic search on the PubMed, Embase, and Web of Science databases, following the PRISMA guidelines. Studies without outcomes of interest, case series with less than four patients, letters, comments, technical notes, editorials, reviews, and basic research papers were excluded. The outcomes considered for this study were: the number of tumors that achieved total resection, subtotal resection, or near total resection, the approach/technique utilized by the surgeon, SF-related complications, and total complications. Five studies, with a total of 175 individuals, were included in our survey. Notably, 70% of the neoplasms presented by the patients were schwannomas. Considering extracranial lesions, we found a proportion of 96% (95% CI: 88 - 100%) in total resection, 0% (95% CI: 0-1%) in near total resection, and 4% (95% CI: 0-12%) in subtotal resection, all linked to an amount of 185 analyzed PNSTs. Furthermore, a proportion of 1% (95% CI: 0 - 2%) in SF-related complications was spotted among 183 patients. Finally, total complications analysis accounted for 11% (95% CI: 0 - 25%) among 183 individuals. We concluded that SF-assisted resection of PNSTs is a suitable and relatively safe technique, linked to minimum complications, of which the majority was not associated with the chemical compound itself. Future research is necessary to increase the number of patients available in the current literature and, therefore, enhance future analyses.
摘要:
周围神经鞘瘤(PNST)的治疗基于手术切除,主要目标是改善症状,同时保留神经功能。为了改进这项技术,外科医生可以使用荧光素钠(SF)来帮助观察肿瘤,因此,促进其移除。为了评估这种新兴手术策略的疗效,我们进行了系统评价和单臂荟萃分析.我们在PubMed上进行了系统的搜索,Embase,和WebofScience数据库,遵循PRISMA准则。没有兴趣结果的研究,少于四名患者的病例系列,信件,注释,技术说明,社论,reviews,基础研究论文被排除在外。本研究考虑的结果是:实现全切除的肿瘤数量,次全切除,或接近完全切除,外科医生使用的方法/技术,SF相关并发症,和总并发症。五项研究,共有175人,包括在我们的调查中。值得注意的是,患者出现的肿瘤中有70%是神经鞘瘤。考虑到颅外病变,我们发现总切除术的比例为96%(95%CI:88-100%),0%(95%CI:0-1%)接近全切除,和4%(95%CI:0-12%)的次全切除,所有这些都与185个分析的PNST相关。此外,在183例患者中发现SF相关并发症的比例为1%(95%CI:0-2%).最后,在183例患者中,总并发症分析占11%(95%CI:0-25%).我们的结论是,SF辅助切除PNST是一种合适且相对安全的技术,与最低限度的并发症有关,其中大多数与化合物本身无关。未来的研究是必要的,以增加现有文献中可用的患者数量,因此,加强未来的分析。