title: Application of fluorescein sodium in the resection of vermis pilocytic astrocytomas.
abstract: BACKGROUND
  Pilocytic astrocytomas (PAs) are slow growing neoplasms and usually located at the cerebellum. There has been certainty regarding the truthful benefit of surgical resection for patients with PA. Gross total resection (GTR) of PAs, especially those being situated in deep regions, remains a surgical challenge. Generally, they are considered as benign and usually develop in young patients. PAs, belonging to WHO I can be cured by radical resection. The patients with PA have excellent prognosis if complete resection can be conducted. The use of fluorescein in vermis PA surgery has not been yet reported. Our data presents fluorescein facilitates surgical resection of vermis PA.
  
  
  METHODS
  Five milligrams per kilogram of fluorescein sodium was intravenously injected directly before general anesthesia for the three patients with PA. The yellow 560 filter was employed for microsurgical tumor resection. Surgical outcomes were assessed concerning the extent of resection.
  
  
  RESULTS
  Most portion of PA in the three cases was found to be highly fluorescent after intravenous fluorescein sodium injection, which markedly enhanced tumor visibility. Gross total resection in all of the patients was achieved without further neurological deficits. No adverse effects and complications resulting from fluorescein sodium were observed over the postoperative course.
  
  
  CONCLUSIONS
  Intraoperative guidance by fluorescein sodium as a new, simple, safe, and practical procedure can enhance the fidelity of tumor tissue and increase the possibility of completely resecting PAs.
authors.affiliation: Department of Neurosurgery, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation, Center for Cancer Medicine, 651 Dong Feng East Road, Guangzhou, 510060, China.
authors.forename: Ji
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation, Center for Cancer Medicine, 651 Dong Feng East Road, Guangzhou, 510060, China.
authors.forename: Fuad
authors.initials: F
authors.lastname: Al-Nahari
authors.affiliation: Department of Neurosurgery, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation, Center for Cancer Medicine, 651 Dong Feng East Road, Guangzhou, 510060, China.
authors.forename: Zi-Feng
authors.initials: ZF
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation, Center for Cancer Medicine, 651 Dong Feng East Road, Guangzhou, 510060, China.
authors.forename: Fu-Hua
authors.initials: FH
authors.lastname: Lin
authors.affiliation: Department of Neurosurgery, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation, Center for Cancer Medicine, 651 Dong Feng East Road, Guangzhou, 510060, China.
authors.forename: Yi-Yin
authors.initials: YY
authors.lastname: Zhao
authors.affiliation: Department of Neurosurgery, The second affiliated hospital of Guangzhou medical university, Guangzhou, China.
authors.forename: Shi-Yin
authors.initials: SY
authors.lastname: Xiao
authors.affiliation: Department of Neurosurgery, Department of Neurosurgery, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, China.
authors.forename: Jian-Min
authors.initials: JM
authors.lastname: Liu
authors.affiliation: Department of Neurosurgery, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation, Center for Cancer Medicine, 651 Dong Feng East Road, Guangzhou, 510060, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Ke
authors.affiliation: Department of Neurosurgery, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation, Center for Cancer Medicine, 651 Dong Feng East Road, Guangzhou, 510060, China.
authors.forename: Zheng-He
authors.initials: ZH
authors.lastname: Chen
authors.affiliation: Department of Anesthesiology, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, 651 Dong Feng East Road, Guangzhou, 510060, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Jiang
authors.affiliation: Department of Thoracic surgery, state Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, 651 Dong Feng East Road, Guangzhou, 510060, China.
authors.forename: Men
authors.initials: M
authors.lastname: Yang
authors.affiliation: Department of Neurosurgery, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation, Center for Cancer Medicine, 651 Dong Feng East Road, Guangzhou, 510060, China.
authors.forename: Ke
authors.initials: K
authors.lastname: Sai
authors.affiliation: Department of Neurosurgery, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation, Center for Cancer Medicine, 651 Dong Feng East Road, Guangzhou, 510060, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation, Center for Cancer Medicine, 651 Dong Feng East Road, Guangzhou, 510060, China. mouyg@sysucc.org.cn.
authors.forename: Yong-Gao
authors.initials: YG
authors.lastname: Mou
mesh_terms: D001254:Astrocytoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D065814:Cerebellar Vermis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D003287:Contrast Media / Q000378:metabolism*; D019793:Fluorescein / Q000378:metabolism*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D019635:Neurosurgical Procedures; D011379:Prognosis
chemical_list: D003287:Contrast Media; D019793:Fluorescein
keywords: Fluorescein sodium; Microscopy; Surgery; Vermis pilocytic astrocytoma