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Fluorescein and the YELLOW 560 Filter in Ganglioglioma surgery
EANS Academy. Höhne J. Sep 27, 2019; 276013; EP12059
Abstract
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Background: Gangliomas comprise a small number of brain tumors. They usually present as WHO °I and seizures are usually the presenting symptom. The surgical goal is complete resection and the course thereafter usually benign. In this study, we retrospectively study the effect of fluorescein-sodium on visualization and resection of Gangliogliomas.
Methods: Surgical database in three Neurosurgical Departments (Regensburg University Hospital, Besta Institute, Milano, Italy and Liv Hospital, Istanbul, Turkey), with approval by local Ethical Committee, were retrospectively reviewed to find gangliogliomas surgically removed by fluorescein-guided technique by the aid of a dedicated filter on the surgical microscope from April 2014 to September 2017. There were 7 patients (5 females, 2 males, mean age 33.7 yeears), all Ganglioglioma WHO °I. Fluorescein was intravenously injected (5 mg/kg) after general anesthesia induction. Tumor was removed in microsurgical technique with the YELLOW 560 Filter (KINEVO/PENTERO 900, Carl Zeiss, Meditec, Oberkochen, Germany).
Results: No side effects related to fluorescein were found. Fluorescein was considered helpful in distinguishing tumor from viable tissue in all cases (100%). In all tumors with contrast enhancement on preoperative MRI fluorescence was noted during the surgical procedure. Gross-total resection was achieved all patients (100%).
Conclusion: Our data suggested a possible positive effect of fluorescein-guided surgery during resection of Gangliogliomas. Further studies may be needed to better elucidate advantages and disadvantages of this technique.
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