Neurooncologic department

Head of the Department - Honored Science Worker of the Russian Federation, Doctor of Medical Science, Prof. Tigliev Georgy Samuilovich

Development of surgery of CNS tumors within the walls of the Leningrad Research Neurosurgical Institute started in the 20s of the last century and was connected with the activity of such eminent clinicians as Polenov A.L. and Molotkov A.G., who were the initiators of the Leningrad neurosurgical school.

In 1938 there appeared two neurooncologic departments headed by Assistant Professor Vaskin I.S. and Candidate of Medical Science Terpugov E.A. The work of the departments was guided by Prof. Babchin I.S., who performed a greater part of the most difficult operations. It is worth mentioning that such operations as removal of pituitary tumors, neurinomas of the VIIIth nerve, meningiomas of the saddle tubercle were made at the above departments before WW II. Such prominent neurologists as Astvatsaturov M.I., Triumfov A.V., Razdolsky I.Ya. took an active part in the work of the departments. Their books on topical diagnosis and semiotics of CNS tumors, based on the experience of their activity, were and are brilliant manuals for many generations of neurosurgeons of the USSR and Russia. Polenov A.L. summarized his rich personal experience of 350 operations for tumors of the brain and spinal cord (the pituitary area, cerebellopontine angle, hemispheres, etc.).

The Great Patriotic War hampered further research in neurooncology. Studying problems of surgical treatment of tumors, in particular tumors of basal and intraventricular localization, was revived only at the beginning of the 50s (Babchin I.S. and Ugriumov V.M.). There were two neurooncologic departments in the postwar period, which were headed by Assistant Professor Vaskin I.S., Doctors of Medical Science Orlova A.N. and A.G. Zhagrin. In 1970 it was decided to leave only one department. Its head was Candidate of Medical Science Nikulenko E.L. (1973-1975). Today it is headed by Doctor of Medical Science, Honored Science Worker, Professor, member of the Cushing's American Association of Neurosurgeons Tigliev G.S.

The 60-70s were devoted to creation of a rational system of anesthesiologic support of interventions, development of foundations of clinical-physiologic control of vital functions and their correction during and after an operation, improvement of surgical approaches. Appearance of up-to-date methods of neurovisualization (CT, MRI, MRIA, PET) brought about a fundamental qualitative improvement of diagnosis and surgery of cerebral tumors.

Surgical approaches, tactics of removal of extracerebral tumors ensuring preservation of adequate blood supply and functions of the brain even in difficult-of-access parastem localization are being developed and introduced. Methods of revascularization with applying a fragment of the greater omentum on ischemic zones have been worked out for compensation of disorders of cerebral hemodynamics. Special attention is paid to improvement of accesses, tactics and technique of surgical treatment of the following most complex and spread neurooncologic pathology:

- basal supratentorial meningiomas of various localization and growth;
- neurinomas of the VIIIth nerve;
- pituitary adenomas;
- neuroectodermal cerebral tumors;
- malignant gliomas;
- tumors of lateral ventricles, a pineal area.

Study of epidemiology of CNS tumors in Saint Petersburg and some regions of Russia, improvement of diagnosis of cerebral tumors at a pre-hospital stage are paid great attention too. There are certain achievements in technical support of microsurgical operations (a neurosurgical microscope, 1992). During the last 15 years employees of the Neurooncologic Department have received 16 patents on inventions; three of them have been patented in the USA. Besides, they have defended theses for a degree of a Doctor (14) and Candidate (49) of Medical Science, published 4 monographs, 2 books of scientific reports, 18 brochures with recommendations on methods of treatment, 14 manuals for doctors.

Introduction of new methods of diagnosis, surgical approaches, ways of treatment led to considerable improvement of results of treatment of neurooncologic cases. Postoperative mortality reduced up to 4.3%. The rate of radical operations reached 68%. Restoration of working ability increased up to 65%. Today the Department has all modern equipment necessary for microsurgery, anesthesiologic support and clinical-physiologic monitoring of vital systems, cranial nerves. It allows to carry out surgical treatment of cases with complex craniobasal tumors, to ensure maximum preservation of cerebral structures and to guarantee a high quality of life of our patients.