Abstract
Introduction: A new technique using a navigation system to minimize the influence of brain shift and to perform precise resection of brain tumors is demonstrated. To determine the resection plane, one to six tubes were inserted around the tumor under the guidance of a navigation system before dural incision.
Results: This technique termed the “navigation-guided fence-post tube” (NGFP) procedure was used to treat 34 patients with intraaxial brain tumors including gliomas (23 cases), malignant lymphomas (4 cases) and metastatic tumors (7 cases). Tumors were removed totally in 23 cases (67.6%), subtotally (95% or more removal) in 6 cases (17.6%) and partially (less than 95% removal) in 5 cases (14.7%). The cases with subtotal or partial resection contained tumors that were close to or involved the eloquent area, or disseminated lesions. No complications due to tube insertion occurred.
Conclusion: NGFP is a useful and safe technique for brain tumor surgery with no influence of brain shift during tumor resection.
Key words
brain tumor - navigation - brain shift - fence-post tube
References
-
1
Kato A, Yoshimine T, Hayakawa T.
A frameless armless navigation system for computer assisted neurosurgery.
J Neurosurg.
1991;
74
845-849
-
2
Dorward NL, Alberti O, Velani B. et al .
Postimaging brain distortion: magnitude, correlates, and impact on neuronavigation.
J Neurosurg.
1998;
88
656-662
-
3
Roessler K, Ungersboeck K, Aichholzer M. et al .
Image-guided neurosurgery comparing a pointer device system with a navigating microscope: a retrospective analysis of 208 cases.
Minim Invas Neurosurg.
1998;
41
37-53
-
4
Gumprecht HK, Widenka DC, Lumenta CB.
BrainLab VectorVision neuronavigation system: technology and clinical experiences in 131 cases.
Neurosurgery.
1999;
44
97-105
-
5
Eisner W, Burtscher J, Bale R. et al .
Use of neuronavigation and electrophysiology in surgery of subcortically located lesions in the sensorimotor strip.
J Neurol Neurosurg Psychiatry.
2002;
72
378-381
-
6
Kajiwara K, Nishizaki T, Ohmoto Y. et al .
Image-guided transsphenoidal surgery for pituitary lesions using Mehrkoordinaten Manipulator (MKM) navigation system.
Minim Invas Neurosurg.
2003;
46
78-81
-
7
Samset E, Hogetveit JO, Cate GT. et al .
Integrated neuronavigation system with intraoperative image updating.
Minim Invas Neurosurg.
2005;
48
73-76
-
8
Stummer W, Stocker S, Wagner S. et al .
Intraoperative detection of malignant gliomas by 5-aminolaevulinic acid-induced porphyrin fluorescence.
Neurosurgery.
1998;
42
518-526
-
9
Matsumoto K, Higashi H, Tomita S. et al .
Resection of deep-seated gliomas using neuroimaging for stereotactic placement of guidance catheters.
Neurol Med Chir (Tokyo).
1995;
35
148-155
-
10
Mori S, Van Zijl PC.
Fiber tracking: principles and strategies – a technical review.
NMR Biomed.
2002;
15
468-480
Correspondence
K. KajiwaraMD
Department of Neurosurgery
Yamaguchi University School of
Medicinem
1-1-1 Minamikogushi
Ube
755-8505 Yamaguchi
Japan
Phone: +81/836/22 2295
Fax: +81/836/22 2294
Email: koji@yamaguchi-u.ac.jp
