[Stereotaxic microsurgical resection of intracranial tumors guided by imaging and assisted by computer].
BACKGROUND
The microsurgical techniques for resection of intracranial lesions are limited where anatomical references do not exist or cannot be used as guides in the dissection of deeply located lesions or in more superficial eloquent areas. The stereotaxic guide, guided by imaging gives precise volumetric and geometric definition in intracranial lesions. Its application in the resection of intracranial tumors has special characteristics due to their biological condition and varied localization.


OBJECTIVE
Spatial orientation during surgery is essential. We show this application of stereotaxic surgery in the Centro Internacional de Restauración Neurológica (CIREN) in La Havana, Cuba, between May 1994 and February 1988, describing 65 microsurgical operations done using stereotaxis in 62 patients with intracranial cerebral tumors.


METHODS
The procedure was divided into three stages: acquiring an image, computerized axial tomography and surgical planning, with the STASSIS planning system and microsurgical procedures, including systems of stereotaxis: Leksell, Micromar and Estereoflex.


RESULTS
Of the total, 27 of these patients had glial tumors, 33 non-glial tumors and only 2 had non-neoplastic lesions of different sites and sizes. A total of 30 resections were done. Surgical morbidity was minimal and there was no surgical mortality.


CONCLUSIONS
The main advantages of this method are: exact localization of the site for craniotomy, easy spatial orientation and ease in distinguishing the delimitation between the tumour and the healthy tissue. It has been shown that Estereoflex may be used in cerebral microsurgery.
Ochoa Zaldivar
L A
LA
Servicio de Neurocirugía; Centro Internacional de Restauración Neurológica (CIREN), La Habana, 11300, Cuba. ochoa@neuro.sld.cu
Estupiñán Díaz
B
B
López Flores
G
G
García Maeso
I
I
Fermín Hernández
E
E
Padrón Sánchez
A
A
Guerra Figueredo
E
E
Teijeiro Amador
J
J
Morales
J M
JM
Jordán
J
J
Villegas Anchón
A
A
Torres
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D013238:Stereotaxic Techniques; D013813:Therapy, Computer-Assisted