A retrospective cohort-matched comparison of conscious sedation versus general anesthesia for supratentorial glioma resection. Clinical article.

OBJECT: Glioma resection under conscious ("awake") sedation (CS) is used for eloquent areas of the brain to minimize postoperative neurological deficits. The objective of this study was to compare the duration of hospital stay, overall hospital cost, perioperative morbidity, and postoperative patient functional status in patients whose gliomas were resected using CS versus general endotracheal anesthesia (GEA). METHODS: Twenty-two cases in 20 patients who underwent surgery for cerebral gliomas under CS and a matched cohort of 22 cases in 19 patients who underwent surgery under GEA over a 3-year period were retrospectively evaluated. Criteria for inclusion in the study were as follows: 1) a single cerebral lesion; 2) gross-total resection as evidenced by postoperative Gd-enhanced MR imaging within 48 hours of surgery; 3) a WHO Grade II, III, or IV glioma; 4) a supratentorial lesion location; 5) a Karnofsky Performance Scale score ≥ 70; 6) an operation performed by the same neurosurgeon; and 7) an elective procedure. RESULTS: The average hospital stay was significantly different between the 2 groups: 3.5 days for patients who underwent CS and 4.6 days for those who underwent GEA. This result translated into a significant decrease in the average inpatient cost after intensive care unit (ICU) care for the CS group compared with the GEA group. Other variables were not significantly different. CONCLUSIONS: Patients undergoing glioma resection using CS techniques have a significantly shorter hospital stay with reduced inpatient hospital expenses after postoperative ICU care.

[Factors affecting the quality of life of patients treated by a combined method for poorly differentiated supratentorial glioma]. / Czynniki wplywajace na zmiany jakosci zycia chorych leczonych w sposób skojarzony z powodu niskozróznicowanych, nadnamiotowych glejaków mózgu.

The quality of life of patients treated for brain tumours and the length of survival are important factors making possible the evaluation of treatment effectiveness. Changes of life quality evaluated by the Karnofsky scale were analysed in a group of 56 patients who have received combined treatment for poorly differentiated supratentorial gliomas. Life quality changes were evaluated after completion of surgical and radiological treatment in relation to preoperative status. The influence of various clinical factors on life quality changes was evaluated. Surgical treatment and tumour site had a significant effect on the stabilization or slight improvement of life quality. The direction and extent of life quality changes were related to surgery, with further change after radiotherapy.

[Surgical treatment on survival and quality of life in patients with supratentorial glioblastoma:].

One hundred one patients with glioblastoma were studied to evaluate the effect of the extent of surgical resection on the length and quality of life. Extensive removal of tumor was performed for 45 patients, while the remaining 56 patients underwent partial removal or biopsy of tumor. The median time to tumor progression and the median survival in the former patients were 18.0 months and 23.0 months, respectively, and, in the latter patients, 6.0 months and 10.0 months, respectively. More than 80% of Karnofsky rating was observed in 69% of the former patients. Extensive removal of glioblastoma would be associated with longer and better survival when compared to partial removal.