Clinical efficacy of multimodal neuro-navigation combined with intraoperative sodium fluorescein in the treatment of intracranial high-grade gliomas
Objective To investigate the clinical efficacy of multimodal neuro-navigation combined with intraoperative sodium fluorescein(SFL)in the treatment of intracranial high-grade gliomas(HGG).Methods The clinical data of 47 patients with HGG(observation group)admitted to the Department of Neurosurgery of Inner Mongolia Autonomous Region People's Hospital from January 2018 to December 2021 were retrospectively analyzed.The patients underwent multimodal image fusion and a preoperative navigation plan was developed before surgery,and multimodal neuronavigation and sodium fluorescein were used to assist in tumor resection during surgery.A total of 47 patients with HGG who underwent tumor resection under microscopy from January 2012 to December 2017 were included as the control group.The baseline data,the degree of tumor resection,the postoperative newly-developed neurological deficits,the improvement of postoperative muscle strength and Karnofsky performance scale(KPS),and the occurrence of complications were compared between the two groups.The Kaplan-Meier survival curve was plotted,and the log-rank test was used to compare the survival of the two groups.Results There were no significant differences in gender,age,tumor location and side,adjacent functional areas,World Health Organization grade of tumor,or preoperative KPS between the observation group and the control group(all P＞0.05).The rate of total tumor resection,the rate of muscle strength improvement after surgery,and the KPS score at 3 months after surgery in the observation group were higher than those in the control group,and the differences were statistically significant(all P＜0.05).The rate of newly-developed neurological dysfunction after surgery was lower than that of the control group(P＜0.05).There were no significant differences in length of hospital stay,duration of surgery,or incidence of complications between the two groups(all P＞0.05).The results of log-rank test showed that the survival rate of patients in the observation group at 6,12 and 18 months(87.2％,53.2％and 21.3％,respectively)was higher than that in the control group(63.8％,27.6％and 10.6％,respectively)(all P＜0.05),and the progression-free survival(4.00±1.91 months vs.2.83±1.59 months)and overall survival(12.49±5.34 months vs.9.26±5.79 months)were significantly greater than those in the control group(all P＜0.05).Conclusion Compared with the traditional microscopic surgery,the resection of HGGs with the assistance of multimodal neuronavigation combined with intraoperative sodium fluorescein seems to be associated with a higher total resection rate,fewer complications,and better survival prognosis.
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