■胶质瘤,最常见的原发性脑肿瘤,由于影响患者生活质量(QOL)和死亡风险增加的潜在缺陷,在雄辩的皮质区域提出了手术挑战。这项研究调查了40例Rolandic皮质胶质瘤切除术后的运动和感觉恢复,除了癫痫发作结果和清醒开颅手术等术中技术的疗效。
■这是一项为期10年的单中心回顾性研究,基于神经外科医生在2011年至2020年期间切除Rolandic胶质瘤的经验及其对40名患者生活质量的影响。主要结果是肿瘤复发和手术疗效定义为生存状态,癫痫发作状态,感觉和运动神经缺陷。数据收集包括人口统计,肿瘤,和手术结果变量。切除范围(EOR)分为全切除(GTR)(EOR≥95%)或次全切除(EOR<95%)。统计分析涉及描述性统计和结果比较的推论检验。
■患者平均年龄为42.3±14岁,男性占72.5%,女性占27.5%。最常见的表现是癫痫发作(65%)。肿瘤位于额叶的65%,电机在75%,肿瘤病理最高的是少突胶质细胞瘤(42.5%)。研究中的复发率为20%(40个中的8个),1年生存率为92.5%。切除后,Karnofsky的表现状态显着改善(P=0.007),在正常的日常活动中(P=0.001),在精细运动技能方面(P=0.020),和工作爱好(P=0.046)。癫痫发作和赤字率没有统计学上的显着改善。复发与人口统计学特征无关,临床表现,肿瘤相关特征(位置,area,侧面,和突变),肿瘤切除,辅助治疗(P>0.05)。
■使用细致的刺激图可以实现Rolandic胶质瘤的GTR,尽管有共同的信念,但完全的功能恢复是可以实现的。
UNASSIGNED: Gliomas, the most common primary brain tumors, pose surgical challenges in eloquent cortex regions due to potential deficits affecting patients\' quality of life (QOL) and increased mortality risk. This study investigates motor and sensory recovery postresection of Rolandic cortex gliomas in 40 patients, alongside seizure outcomes and the efficacy of intraoperative techniques such as awake craniotomy.
UNASSIGNED: This was a 10-year monocentric retrospective study based on the experience of a neurosurgeon in the resection of Rolandic gliomas and its impact on 40 patients\' QOL in a period from 2011 to 2020. The primary outcomes were tumor recurrence and the efficacy of the surgery defined as survival status, seizure status, and sensory and motor neurological deficits. Data collection included demographic, tumor, and surgical outcome variables. The extent of resection (EOR) was classified as gross total resection (GTR) (EOR ≥95%) or subtotal resection (EOR <95%). Statistical analysis involved descriptive statistics and inferential tests for outcome comparisons.
UNASSIGNED: Patients were aged an average of 42.3 ± 14 years and distributed between 72.5% of males and 27.5% of females. The most common presentation was seizures (65%). The tumor was located in the frontal lobe at 65%, the motor at 75%, and the top tumor pathology was oligodendroglioma (42.5%). The recurrence rate in the study was 20% (8 of 40), and the 1-year survival rate was 92.5%. After the resection, significant improvement was shown in Karnofsky\'s performance status (P = 0.007), in normal daily activities (P = 0.001), in fine motor skills (P = 0.020), and work hobbies (P = 0.046). No statistically significant improvement was shown in seizures and deficit rates. Recurrence was not associated with the demographic characteristics, clinical presentation, tumor-related characteristics (location, area, side, and mutation), tumor resection, and adjuvant treatment (P > 0.05).
UNASSIGNED: GTR of Rolandic gliomas can be achieved with the use of meticulous stimulation mapping, and complete functional recovery is attainable despite common belief.