Basic Surgical Techniques in the Resection of Malignant Gliomas

Although progress is being made in the imaging and medical therapy of malignant gliomas, surgery continues to play a central role in the management of these tumors. Surgery remains necessary for histological diagnosis and relief of mass effect upon adjacent neurological structures. Surgery also achieves cytoreduction of tumor mass, allowing more effective treatment of residual tumor volume. Recent technical advances have made the goal of gross total tumor resection safer and more readily achieved. Surgical techniques and adjuncts that aid the aggressive surgical resection of malignant gliomas will be reviewed.

[1]  P. Warnke,et al.  Surgical resection and radiation therapy versus biopsy and radiation therapy in the treatment of glioblastoma multiforme. , 1993, Journal of neurosurgery.

[2]  J G Ojemann,et al.  Preserved function in brain invaded by tumor. , 1996, Neurosurgery.

[3]  K. Hirakawa,et al.  Multivariate analysis of factors affecting postoperative survival in malignant astrocytoma , 1984, Journal of Neuro-Oncology.

[4]  C. Avezaat,et al.  The influence of the extent of surgery of the neurological function and survival in malignant glioma , 1990 .

[5]  D. Nelson,et al.  Recursive partitioning analysis of prognostic factors in three Radiation Therapy Oncology Group malignant glioma trials. , 1993, Journal of the National Cancer Institute.

[6]  M. Berger.  Malignant astrocytomas: surgical aspects. , 1994, Seminars in oncology.

[7]  M. Mikhael,et al.  Supratentorial gliomas: surgical considerations and immediate postoperative results. Gross total resection versus partial resection. , 1987, Neurosurgery.

[8]  The Cerebral Metabolic Effects of Isoflurane at and above Concentrations that Suppress Cortical Electrical Activity , 1983, Anesthesiology.

[9]  P. Gutin,et al.  Reoperation for recurrent glioblastoma and anaplastic astrocytoma. , 1987, Neurosurgery.

[10]  C. Prys‐roberts,et al.  Air embolism , 1971, Anaesthesia.

[11]  G H Barnett,et al.  Nonvolumetric stereotaxy-assisted craniotomy. Results in 50 consecutive cases. , 1993, Stereotactic and functional neurosurgery.

[12]  J. Cairncross,et al.  Supratentorial anaplastic gliomas in adults. The prognostic importance of extent of resection and prior low-grade glioma. , 1989, Journal of neurosurgery.

[13]  J. Michenfelder,et al.  Cerebral Protection by Isoflurane during Hypoxemia or Ischemia , 1983, Anesthesiology.

[14]  D. Holaday,et al.  Clinical Characteristics and Biotransformation of Sevoflurane in Healthy Human Volunteers , 1981, Anesthesiology.

[15]  A. Brain.  The laryngeal mask--a new concept in airway management. , 1983, British journal of anaesthesia.

[16]  M. Salcman.  Malignant glioma management. , 1990, Neurosurgery clinics of North America.

[17]  Medical Research Council.  Prognostic factors for high-grade malignant glioma: Development of a prognostic index , 2004, Journal of Neuro-Oncology.

[18]  M. Salcman,et al.  Long-term survival in patients with malignant astrocytoma. , 1994, Neurosurgery.

[19]  R. Roselli,et al.  Staging of supratentorial hemispheric glioma using tumour extension, histopathological grade and extent of surgical resection , 1993, The British journal of surgery.

[20]  W. Powlis,et al.  Does extent of surgery influence outcome for astrocytoma with atypical or anaplastic foci (AAF)? A report from three Radiation Therapy Oncology Group (RTOG) trials , 1992, Journal of Neuro-Oncology.

[21]  K. Kitaguchi,et al.  Effects of Sevoflurane on Cerebral Circulation and Metabolism in Patients with Ischemic Cerebrovascular Disease , 1993, Anesthesiology.

[22]  S B Green,et al.  The prognostic importance of tumor size in malignant gliomas: a computed tomographic scan study by the Brain Tumor Cooperative Group. , 1988, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[23]  Gene H. Barnett,et al.  Use of a Frameless, Armless Stereotactic Wand for Brain Tumor Localization with Two-Dimensional and Three-Dimensional Neuroimaging , 1993 .

[24]  R. Sawaya,et al.  Use of intraoperative ultrasound for localizing tumors and determining the extent of resection: a comparative study with magnetic resonance imaging. , 1996, Journal of neurosurgery.

[25]  H. Thaler,et al.  Morbidity and mortality of craniotomy for excision of supratentorial gliomas , 1988, Neurology.

[26]  D. Warner,et al.  Effects of Iso‐osmolal Intravenous Fluid Therapy on Post‐ischemic Brain Water Content in the Rat , 1988, Anesthesiology.

[27]  J D Michenfelder,et al.  The effects of dextrose infusion and head position on neurologic outcome after complete cerebral ischemia in primates: examination of a model. , 1987, Anesthesiology.

[28]  F. Plum,et al.  Increased damage after ischemic stroke in patients with hyperglycemia with or without established diabetes mellitus. , 1983, The American journal of medicine.

[29]  D. Silbergeld,et al.  Isolation and characterization of human malignant glioma cells from histologically normal brain. , 1997, Journal of neurosurgery.

[30]  M. Ammirati,et al.  Reoperation in the treatment of recurrent intracranial malignant gliomas. , 1987, Neurosurgery.

[31]  N. Rossi,et al.  Catecholamine response to intracranial hypertension. , 1978, Journal of neurosurgery.

[32]  P J Kelly,et al.  Resection, biopsy, and survival in malignant glial neoplasms. A retrospective study of clinical parameters, therapy, and outcome. , 1993, Journal of neurosurgery.

[33]  P. Kelly,et al.  Computer-assisted stereotaxic laser resection of intra-axial brain neoplasms. , 1986, Journal of neurosurgery.

[34]  J. Maroon,et al.  Value of surgical intervention in the treatment of glioma. , 1995, Stereotactic and functional neurosurgery.