目的:周围神经肿瘤的主要治疗包括保留神经功能的最大限度手术切除。荧光素钠显示出增强神经肿瘤手术安全性和有效性的潜力。这篇综述评估了荧光素钠在这方面的优点和局限性。
方法:PubMed,EMBASE,Web-of-Science,根据PRISMA-ScR指南对Scopus进行了检索,纳入了报告荧光素钠在周围神经肿瘤手术中使用的研究.干预相关结果(即,切除范围,临床结果,并发症发生率,复发率,和手术持续时间)进行评估和总结。
结果:共纳入4项研究,包括166例患者和168例肿瘤。患者多为女性(98;53.6%),101(69.2%)有散发性(非综合征性)肿瘤,在组织病理学上,114例(67.9%)肿瘤为WHO1级神经鞘瘤。146例(86.9%)肿瘤全部切除。术后并发症16例(10.2%),与荧光染料的副作用无关。在150个(94.3%)肿瘤中报告了高肿瘤荧光,虽然在121(79.6%)和27(17.8%)中报告了缺乏和低亲性神经荧光,分别。手术的中位持续时间为51.5(范围:24-92)分钟。
结论:荧光素钠通过促进肿瘤之间的分化,有望作为神经肿瘤手术的辅助工具,母体神经,和周围的软组织。然而,多中心随机对照试验是必要的,以确定其对切除率范围的影响,临床结果,术后并发症发生率,与目前的护理标准相比,手术时间。
OBJECTIVE: The primary treatment for peripheral nerve tumors involves maximal surgical resection while preserving nerve function. Sodium fluorescein shows potential for enhancing the safety and efficacy of nerve tumor surgery. This review evaluates the advantages and limitations of sodium fluorescein in this context.
METHODS: PubMed, EMBASE, Web-of-Science, and Scopus were searched following the PRISMA-ScR guidelines to include studies reporting the use of sodium fluorescein in peripheral nerve tumors surgery. Intervention-related outcomes (i.e., extent of resection, clinical outcomes, complication rates, recurrence rates, and duration of surgery) were evaluated and summarized.
RESULTS: A total of 4 studies encompassing 166 patients with 168 tumors were included. Patients were mostly female (98; 53.6%), 101 (69.2%) had sporadic (non-syndromic) tumors, and at histopathology, 114 (67.9%) tumors were WHO grade-1 schwannomas. Gross total resection was achieved in 146 (86.9%) tumors. Postoperative complications were reported in 16 cases (10.2%%), none related to side effects of the fluorescent dye. High tumor fluorescence was reported in 150 (94.3%) tumors, while absent and low parent nerve fluorescence was reported in 121 (79.6%) and 27 (17.8%), respectively. The median duration of surgery was 51.5 (range: 24-92) minutes.
CONCLUSIONS: Sodium fluorescein shows promise as assisting tool in nerve tumor surgery by facilitating differentiation between the tumor, parent nerve, and surrounding soft tissue. However, multi-center randomized controlled trials are necessary to determine its effect on extent of resection rates, clinical outcomes, postoperative complication rates, and surgical duration in comparison to current standard of care.