RÉSUMÉ
Objective To explore the impact of MR imaging T2 fluid-attenuated inversion-recovery sequence (MRI T2Flair) excision extension and postoperative chemotherapy in prognosis of patients with glioblastoma (GBM). Methods A retrospective study of clinical data and treatment efficacy of 17 patients with GBM, admitted to our hospital from April 2012 to August 2016, was performed. All patients were performed tumor resection by using awake anesthesia, neuroimage navigation, and intraoperative direct electrical stimulation. The impacts of the resection extent of T2Flair lesions and adjuvant chemotherapy on the prognosis of glioblastoma were analyzed. Results T1 enhanced lesions in these 17 patients were totally resected. The median follow-up duration was 18 months (8 months to 52 months). Median survival time was 20 months; the survival time of patients with resection ranges of 0%-10%, 10%-25% and more than 25% were 19, 22 and 24 months, respectively, without statistical differences (P>0.05). The patients adopted less than 6 courses chemotherapy had a 19-month-long median survival time, and those adopted 6 courses or more courses chemotherapy had a 33-month-long median survival time, with statistically significant difference (P<0.05). Conclusion When T1 enhanced lesions are totally resected, the resection extent of T2Flair lesions has no influence on patients survival time; however, patients accepted 6 or more courses of chemotherapy have a better survival.
RÉSUMÉ
Objective To investigate the surgical safety and clinical efficacy of resection of deep brain lesions by using awake anesthesia and multiple positioning technology.Methods A retrospective analysis of clinical data and surgical treatments of 77 patients with deep brain lesions,admitted to our hospital from September 2013 and September 2014,was performed.Craniotomy was performed under general anesthesia,and then,awaking up of patient during surgery was achieved.Under awake state,the boundary of the lesions was mapped by neuroimage navigation technology,and language and movement functional areas were located using direct cortex evoked potential or cortical electrical stimulation.The deep brain lesions were removed according to anatomic-functional boundaries.Patients were followed up for 3 months.Results Intra-operative awaking up was successful in 74 patients.Language areas were identified in 8 patients,and movement functional areas were detected in 38 patients.Total resection was achieved in 51 patients,sub-total resection in 24 and 2 partial removals.Postoperative temporary movement barriers were noted in 10 patients and language barriers in 2 patients.Conclusion The deep brain lesions can be maximally removed by combined neuroimage navigation with cortical electrical stimulate under awake anesthesia,which can significantly protect the important brain functions and improve the quality of patients life after surgery.