title: Summary of 15 years experience of awake surgeries for neuroepithelial tumors in tohoku university.
abstract: We retrospectively analyzed 15 years experience of awake surgeries for neuroepithelial tumors in Tohoku University. Awake surgeries mostly for language mapping were performed for 42 of 681 newly diagnosed cases (6.2%) and 59 of 985 surgeries including for recurrence (6.0%). When the same histologies and locations as cases resected under awake condition are selected from the parent population treated by radical resection, awake surgeries were most frequently performed for 14 of 55 newly diagnosed cases (25.5%) and 14 of 62 surgeries (22.6%) with grade II gliomas. In the results, 8 of 59 surgeries (13.6%) could not achieve complete language monitoring until the final stage of tumor resection, considered as failed awake surgery. Gross total resection was accomplished in 20 of 42 newly diagnosed cases (47.6%) and 32 of 59 surgeries (54.2%). Mortality rate was 0%. Late severe deficits were observed in 2 of 42 newly diagnosed cases (4.8%) and 3 of 59 surgeries (5.1%). Negative language mapping cases did not suffer severe deficits in both early and late stages. In contrast, high incidence of severe deficits, 3 as early and 2 as late of 8 cases, were identified with failed awake surgery. The overall survival of patients treated by awake surgery compared favorably with those treated without stimulation mapping and with stimulation mapping under general anesthesia. Awake surgery may contribute to improve the outcome of gliomas near eloquent areas by maximizing the tumor resection and minimizing the surgical morbidity.
authors.affiliation: Department of Neurosurgery, Tohoku University Graduate School of Medicine, Kitasato, Minami-ku, Sagamihara, Japan. Kuma@kitasato-u.ac.jp
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Kumabe
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Sato
authors.forename: Masaki
authors.initials: M
authors.lastname: Iwasaki
authors.forename: Ichiyo
authors.initials: I
authors.lastname: Shibahara
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Kawaguchi
authors.forename: Ryuta
authors.initials: R
authors.lastname: Saito
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kanamori
authors.forename: Yoji
authors.initials: Y
authors.lastname: Yamashita
authors.forename: Yukihiko
authors.initials: Y
authors.lastname: Sonoda
authors.forename: Osamu
authors.initials: O
authors.lastname: Iizuka
authors.forename: Kyoko
authors.initials: K
authors.lastname: Suzuki
authors.forename: Ken-Ichi
authors.initials: K
authors.lastname: Nagamatsu
authors.forename: Shintaro
authors.initials: S
authors.lastname: Seki
authors.forename: Nobukazu
authors.initials: N
authors.lastname: Nakasato
authors.forename: Teiji
authors.initials: T
authors.lastname: Tominaga
mesh_terms: D000328:Adult; D000368:Aged; D000758:Anesthesia / Q000379:methods*; D001931:Brain Mapping / Q000379:methods*; D001932:Brain Neoplasms / Q000503:physiopathology* / Q000601:surgery*; D002540:Cerebral Cortex / Q000473:pathology / Q000601:surgery; D004558:Electric Stimulation; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007564:Japan; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000503:physiopathology / Q000601:surgery; D018302:Neoplasms, Neuroepithelial / Q000503:physiopathology* / Q000601:surgery*; D011379:Prognosis; D012086:Reoperation; D012189:Retrospective Studies; D013060:Speech / Q000502:physiology*; D014851:Wakefulness; D055815:Young Adult