Differential application of laser and navigation technologies in surgery of periventricular oligoastrocytomas
Abstract
Objective – to improve treatment results in patients with periventricular oligoastrocytomas.
Materials and methods. Oligoastrocytoma (OA) WHO Grade II was diagnosed in 16 (19.8 %) patients, OA WHO Grade III – in 65 (80.2 %). Diagnostic included the analysis of CT, MRI, SPECT in native modes and with contrast enhancement. As a source of laser radiation, the semiconductor laser «Lika-Chirurg» (wave length 0.808 and 1.47 p,m, 30 and 7 W) was used. The navigational support for surgical interventions was carried out using the Medtronic StealthStation TREONPlus (Medtronic, USA) surgical navigation system.
Results. In 27 (33.3 %) patients with OA was a predominance of oligodendroglial component, in 28 (34.6 %) – astrocytic component, in 26 (32.1 %) – an equal representation of both components cells. The surgical treatment was the following: total removal – in 55 (67.9 %) patients, subtotal removal – in 26 (22.1 %). In the presurgery period quality of life with KRI > 80 % was assessed in 34 (41.9 %) patients, in postsurgery period – in 77 (95.1 %).
Conclusions. Differential use of laser technologies and navigation support, taking into account the OA histology and topography, allows to optimize surgical tactics and totally remove a tumor without neural structuresinjury.
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