[Microsurgical technique of brain glioma---a report of 183 cases].
OBJECTIVE
Prognosis of glioma is still poor, its main treatment is surgery. The extent of tumor resection relates with prognosis. This study was to evaluate the extent of resection, post-operative Karnofsky performance scale (KPS), and survival rate of the glioma patients received microsurgery.


METHODS
Records of 183 glioma patients received microneurosurgery were retrospectively analyzed, the extent of resection, post-operative KPS, and survival rate of patients were evaluated. Different microsurgical techniques were applied according to the location of gliomas. En bloc resection was performed for gliomas in non-functional areas by dissecting the tumors along edema area with high-power bipolar electrocoagulation. The tumors in functional areas were separated along cortex sulcus, the central part of tumor was removed firstly, and residual part was resected with low-power electrocoagulation. Gliomas close to important vessels were sucked, and electrocoagulation seldom performed.


RESULTS
Among 183 cases of glioma, 85 in non-functional area, 47 in functional area, and 51 close to important vessels. Total and sub-total resection was performed in 163 patients (89.1%). The average post-operative KPS was 74. The KPS was decreased in 23 patients, increased in 44 patients, and stable in 116 patients. Patients were followed up for 12-216 months with an average of 47.8 months. The follow-up rate was 100%. Among 113 patients with long-term follow-up (>/=5 years), 5-year survival rates of low-grade, and high-grade astrocytoma patients were 75.4% (52/69), and 18.2% (8/44).


CONCLUSIONS
Using different microsurgical patterns according to location of glioma, maximal resection of tumor may achieve with protection of neurological function.
Mu
Yong-Gao
YG
Department of Neurosurgery, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong 510 060, P.R. China.
Chen
Ming-Zhen
MZ
Chen
Zhong-Ping
ZP
Zhou
Wang-Ning
WN
Zhang
Xiang-Heng
XH
Sai
Ke
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D001254:Astrocytoma / Q000601:surgery; D001932:Brain Neoplasms / Q000601:surgery*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D005909:Glioblastoma / Q000601:surgery; D005910:Glioma / Q000601:surgery*; D006801:Humans; D017567:Karnofsky Performance Status; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods; D012189:Retrospective Studies; D015996:Survival Rate