title: Predictive factors for beneficial application of high-frequency electromagnetics for tumour vaporization and coagulation in neurosurgery.
abstract: OBJECTIVE
  To identify preoperative and intraoperative factors and conditions that predicts the beneficial application of a high-frequency electromagnetic field (EMF) system for tumor vaporization and coagulation.
  
  
  METHODS
  One hundred three subsequent patients with brain tumors were microsurgically treated using the EMF system in addition to the standard neurosurgical instrumentarium. A multivariate analysis was performed regarding the usefulness (ineffective/useful/very helpful/essential) of the new technology for tumor vaporization and coagulation, with respect to tumor histology and location, tissue consistency and texture, patients' age and sex.
  
  
  RESULTS
  The EMF system could be used effectively during tumor surgery in 83 cases with an essential contribution to the overall success in 14 cases. In the advanced category of effectiveness (very helpful/essential), there was a significant difference between hard and soft tissue consistency (50 of 66 cases vs. 3 of 37 cases). The coagulation function worked well (very helpful/essential) for surface (73 of 103 cases) and spot (46 of 103 cases) coagulation when vessels with a diameter of less than one millimeter were involved. The light-weight bayonet hand piece and long malleable electrodes made the system especially suited for the resection of deep-seated lesions (34 of 52 cases) compared to superficial tumors (19 of 50 cases). The EMF system was less effective than traditional electrosurgical devices in reducing soft glial tumors. Standard methods where also required for coagulation of larger vessels.
  
  
  CONCLUSIONS
  It is possible to identify factors and conditions that predict a beneficial application of high-frequency electromagnetics for tumor vaporization and coagulation. This allows focusing the use of this technology on selective indications.
authors.affiliation: Department of Neurosurgery, Eberhard Karls University, Tübingen, Germany. not@valid.com
authors.forename: Rainer
authors.initials: R
authors.lastname: Ritz
authors.forename: Stefan
authors.initials: S
authors.lastname: Heckl
authors.forename: Sam
authors.initials: S
authors.lastname: Safavi-Abbasi
authors.forename: Guenther C
authors.initials: GC
authors.lastname: Feigl
authors.forename: Boris
authors.initials: B
authors.lastname: Krischek
authors.forename: Wolf
authors.initials: W
authors.lastname: Lüdemann
authors.forename: Javed M
authors.initials: JM
authors.lastname: Mirzayan
authors.forename: Andrei
authors.initials: A
authors.lastname: Koerbel
authors.forename: Madjid
authors.initials: M
authors.lastname: Samii
authors.forename: Marcos
authors.initials: M
authors.lastname: Tatagiba
authors.forename: Alireza
authors.initials: A
authors.lastname: Gharabaghi
mesh_terms: D001932:Brain Neoplasms / Q000601:surgery*; D004564:Electrocoagulation / Q000295:instrumentation*; D004574:Electromagnetic Fields; D004598:Electrosurgery / Q000295:instrumentation*; D006801:Humans; D008866:Microsurgery / Q000295:instrumentation*; D019635:Neurosurgical Procedures / Q000295:instrumentation; D014835:Volatilization