Surgical considerations for maximal safe resection of exophytic brainstem glioma in the pediatric age group

BACKGROUND: Brainstem glioma is the leading cause of morbidity and mortality among all central nervous system tumors, especially in childhood as it represents about 20% of all pediatric brain tumors. Therefore, this study aimed to present our experience in a tertiary center in a developing country w...

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Autores principales: Mahmoud, Ayman Tarek, Enayet, Abdelrhman, Alselisly, Ahmed Mohamed Ahmed
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Scientific Scholar 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8326137/
https://www.ncbi.nlm.nih.gov/pubmed/34345451
http://dx.doi.org/10.25259/SNI_318_2021
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author Mahmoud, Ayman Tarek
Enayet, Abdelrhman
Alselisly, Ahmed Mohamed Ahmed
author_facet Mahmoud, Ayman Tarek
Enayet, Abdelrhman
Alselisly, Ahmed Mohamed Ahmed
author_sort Mahmoud, Ayman Tarek
collection PubMed
description BACKGROUND: Brainstem glioma is the leading cause of morbidity and mortality among all central nervous system tumors, especially in childhood as it represents about 20% of all pediatric brain tumors. Therefore, this study aimed to present our experience in a tertiary center in a developing country with limited resources for the surgical management of exophytic brainstem gliomas. METHODS: This retrospective study included pediatric patients with brainstem (midbrain, pontine, or medullary) focal or diffuse gliomas whether low or high grade that had dorsal, ventral, or lateral exophytic component who were presented to our hospitals from January 2019 to January 2021. The patients’ data were collected, such as age, sex, preoperative and postoperative clinical condition, radiological data, surgical approach, extent of tumor removal, histopathology, follow-up period, and adjuvant therapy. RESULTS: A total of 23 patients were included in this study. The telovelar approach was used in 17 patients, the supracerebellar infratentorial approach in three patients, and the retrosigmoid, transcerebellar, and occipital transtentorial approach once for each patient. Twenty patients underwent near-total excision, and three underwent subtotal excision. Two-thirds of our cases (17 patients) were low-grade gliomas, with the remaining one-third comprising entirely of either anaplastic astrocytoma (five patients) or glioblastoma multiforme (one patient). The follow-up period of the patients extended from 3 months to 24 months. CONCLUSION: Exophytic brainstem glioma surgery can result in good outcomes with minimal complications when near-total excision is attempted through a properly chosen approach and adherence to some surgical techniques and considerations.
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spelling pubmed-83261372021-08-02 Surgical considerations for maximal safe resection of exophytic brainstem glioma in the pediatric age group Mahmoud, Ayman Tarek Enayet, Abdelrhman Alselisly, Ahmed Mohamed Ahmed Surg Neurol Int Original Article BACKGROUND: Brainstem glioma is the leading cause of morbidity and mortality among all central nervous system tumors, especially in childhood as it represents about 20% of all pediatric brain tumors. Therefore, this study aimed to present our experience in a tertiary center in a developing country with limited resources for the surgical management of exophytic brainstem gliomas. METHODS: This retrospective study included pediatric patients with brainstem (midbrain, pontine, or medullary) focal or diffuse gliomas whether low or high grade that had dorsal, ventral, or lateral exophytic component who were presented to our hospitals from January 2019 to January 2021. The patients’ data were collected, such as age, sex, preoperative and postoperative clinical condition, radiological data, surgical approach, extent of tumor removal, histopathology, follow-up period, and adjuvant therapy. RESULTS: A total of 23 patients were included in this study. The telovelar approach was used in 17 patients, the supracerebellar infratentorial approach in three patients, and the retrosigmoid, transcerebellar, and occipital transtentorial approach once for each patient. Twenty patients underwent near-total excision, and three underwent subtotal excision. Two-thirds of our cases (17 patients) were low-grade gliomas, with the remaining one-third comprising entirely of either anaplastic astrocytoma (five patients) or glioblastoma multiforme (one patient). The follow-up period of the patients extended from 3 months to 24 months. CONCLUSION: Exophytic brainstem glioma surgery can result in good outcomes with minimal complications when near-total excision is attempted through a properly chosen approach and adherence to some surgical techniques and considerations. Scientific Scholar 2021-06-28 /pmc/articles/PMC8326137/ /pubmed/34345451 http://dx.doi.org/10.25259/SNI_318_2021 Text en Copyright: © 2021 Surgical Neurology International https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Mahmoud, Ayman Tarek
Enayet, Abdelrhman
Alselisly, Ahmed Mohamed Ahmed
Surgical considerations for maximal safe resection of exophytic brainstem glioma in the pediatric age group
title Surgical considerations for maximal safe resection of exophytic brainstem glioma in the pediatric age group
title_full Surgical considerations for maximal safe resection of exophytic brainstem glioma in the pediatric age group
title_fullStr Surgical considerations for maximal safe resection of exophytic brainstem glioma in the pediatric age group
title_full_unstemmed Surgical considerations for maximal safe resection of exophytic brainstem glioma in the pediatric age group
title_short Surgical considerations for maximal safe resection of exophytic brainstem glioma in the pediatric age group
title_sort surgical considerations for maximal safe resection of exophytic brainstem glioma in the pediatric age group
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8326137/
https://www.ncbi.nlm.nih.gov/pubmed/34345451
http://dx.doi.org/10.25259/SNI_318_2021
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