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DOI: 10.1055/s-0042-1758210
Literature Review: Role of Neurosurgery in Leptomeningeal Carcinomatosis
Crítica literária: Papel da neurocirurgia na Carcinomatose Leptomeníngea
Abstract
Introduction Leptomeningeal carcinomatosis results from metastatic neoplastic cells that reach the leptomeninges through the cerebrospinal fluid. The presentation of the disease is variable, making prognosis challenging. However, the presence of intracranial hypertension is common, which has prompted new treatments to mitigate this effect.
Objective To report the role of neurosurgery in the treatment of leptomeningeal carcinomatosis, as well as its advances.
Methodology Literature review with a search of the PubMed database, between 2011 and 2021, using the following descriptors: Neurosurgery, Leptomeningeal Carcinomatosis, Cerebrospinal and Treatment. A total of 42 articles were found, 16 of which were selected.
Results The shunt insertion considerably improved the effects of cranial hypertension, increasing the average survival time of patients by 3.5 months after surgery. The Ommaya reservoir is also a viable option due to its convenience and safety. The V-Port, on the other hand, has overcome the challenges of conventional devices, with shorter operating times (42 minutes), smaller skin incisions, and no reports of postoperative infection.
Conclusion Devices for the treatment of leptomeningeal carcinomatosis have been steadily improving, simplifying surgical procedures and benefiting patients.
Resumo
Introdução A carcinomatose leptomeníngea resulta de células neoplásicas metastáticas que atingem as leptomeninges através do líquido cefalorraquidiano. A apresentação da doença é variável, tornando o prognóstico desafiador. No entanto, a presença de hipertensão intracraniana é comum, o que levou a novos tratamentos para mitigar esse efeito.
Objetivo Relatar o papel da neurocirurgia no tratamento da carcinomatose leptomeníngea, bem como seus avanços.
Metodologia Crítica literária com busca na base de dados PubMed, entre 2011 e 2021, utilizando os seguintes descritores: Neurocirurgia, Carcinomatose Leptomeníngea, Cefalorraquidiana e Tratamento. Foram encontrados 42 artigos, dos quais 16 foram selecionados.
Resultados A inserção do shunt melhorou consideravelmente os efeitos da hipertensão craniana, aumentando o tempo médio de sobrevida dos pacientes em 3,5 meses após a cirurgia. O reservatório de Ommaya também é uma opção viável devido à sua conveniência e segurança. O V-Port, por outro lado, superou os desafios dos dispositivos convencionais, com tempos de operação mais curtos (42 minutos), incisões cutâneas menores e sem relatos de infecção pós-operatória.
Conclusão Os dispositivos para o tratamento da carcinomatose leptomeníngea vêm melhorando constantemente, simplificando os procedimentos cirúrgicos e beneficiando os pacientes.
* Thaís Mitie Ogasawara and Thaís Yumi Kobayashi Batista collected data and wrote the manuscript.
Ana Carla Mondek Rampazzo, Caroline Amane Pessoa Badaoui, Igor Ruan de Araújo Caetano, Jonathan Vinícius Martins and Maria Letícia Nogueira collected data. Rafael Rodrigues Pinheiro dos Santos, José Ângelo Guarnieri and Carlos Alexandre Martins Zicarelli guided the study and reviewed the manuscript.
Publication History
Received: 17 April 2022
Accepted: 12 July 2022
Article published online:
18 October 2023
© 2023. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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