Yu.A. Losev, V.P. Bersnev, I.V. Polyakov
(Faculty of Neurosurgery, Saint Petersburg Medical Academy of Postgraduate Education
Hospital of the Leningradskaya Region)
Cerebral tumors occupy a peculiar place in the structure of morbidity, mortality and invalidism of the most able-bodied population. High social and economic losses, caused by this pathology and suffered by the society, make care of this category of patients to be one of the most urgent problems of neurosurgery and public health.
The study was carried out on the territory of the Leningradskaya region. A rate of primary cerebral tumors was 6.98 of cases per 100 000 people. The structure of primary tumors, diagnosed in rural population of the region, was as follows: neuroectodermal tumors – 37.3%, meningiomas - 25.7%, tumors of the chiasm-sellar area – 9.9%, neurinomas of the acoustic nerve – 6.4% of cases.
Besides unfavorable ecologic environment, typical of the Leningadskaya region, a risk of development of cerebral tumors included such factors as presence of craniocerebral trauma in history (8.3% of cases); previous courses of radiation therapy (0.3% of cases); work at poultry farms, atomic power plants and being a driver (9.9% of cases).
Operations were performed in 230 patients (61.7% of all cases). A volume of resection and surgical tactics were dependent a histological structure, size and localization of tumor as well as a patient’s state and technical equipment of a hospital.
Postoperative mortality and complications were 4.4% and 21.3% respectively. Disability was watched in 26.1% of all cases with primary cerebral tumors.
New neurosurgical technologies promoted early diagnosis of primary cerebral tumors and their timely treatment. Diagnosis was 2-5 times better in those areas of the region, which were equipped with modern high-precision apparatus.
Among the causes of late diagnosis of cerebral tumors one can mention low “oncologic alertness” of doctors of outpatient departments and imperfect diagnostic equipment of rural medical establishments.