Intraoperative Navigation in Little-Invasive Surgery of Cerebral Tumors

Lapshin R., Savello ., Svistov D.

Medicomilitary Academy, Saint Petersburg, Russia

 

The nearest results of surgical interventions were estimated with the purpose of optimizing intraoperative navigation and determining its effect on efficacy of tumor removal.

The research comprised 163 cases with cerebral tumors, treated in the Clinic of Neurosurgery of the Medicomilitary Academy in 2004-2006. Surgical intervention was planned with applying the Stealth StationTM navigation system (the USA). Ultrasonic intraoperative navigation was used as well.

The analysis of surgery results demonstrated an increased quota of totally removed tumors in the main group, as compared to the control one (71.2% and 63.2% respectively). It was confirmed by data of control CT and MRI examinations, carried out in an early postoperative period. The analysis of a structure of intraoperative complications showed, that their rate in the main and control groups was 7% and 24.6% respectively. A dominant intraoperative complication, watched in both groups, was brain edema. As for a structure of postoperative complications, 85.7% of cases of the main group and 68.9% of patients of the control group had an uncomplicated course. Dynamics of neurological complications, observed in a preoperative period and at the moment of discharge, was analyzed. According to the obtained results, 47.2% of cases of the main group and 43.9% of patients of the control group were discharged with a state improvement. Its worsening or absence of any dynamics were watched in 13.2% and 22.8% of cases and 38.7% and 29.8% of patients respectively.

Use of the Stealth StationTM navigation system, intraoperative sonography permitted to reduce operation invasiveness, to increase its efficacy, to optimize a surgical access, to minimize a risk of damaging functionally eloquent areas and cerebral vessels.