Maximizing safe resections: the roles of 5-aminolevulinic acid and intraoperative MR imaging in glioma surgery-review of the literature.
Maximizing safe resections: the roles of 5-aminolevulinic acid and intraoperative MR imaging in glioma surgery-review of the literature.
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最大化的安全切除术：5-氨基乙酸和术中MR成像在文献中的胶质瘤手术审查中的作用。
DOI：
10.1007/s10143-017-0907-z
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发表时间：
2019-06
影响因子：
2.8
通讯作者：
Stummer W
中科院分区：
文献类型：
--
作者：
Suero Molina E;Schipmann S;Stummer W
恶性胶质瘤手术涉及在追求最大肿瘤切除的同时保留具有这些病变的患者的神经系统状态的挑战，这与总体和无进展生存期相关。目前，存在几种工具用于辅助神经外科医生可视化恶性组织。在过去的十年中，使用5-氨基乙酰丙酸（5-ALA）的脑胶质瘤引导手术（FGS）越来越多地用于识别恶性胶质瘤。20世纪90年代中期首次引入的术中磁共振成像（iMRI）正在被评估为最大限度地扩大切除范围的进一步工具。我们的目的是评价文献，并讨论FGS与5-ALA和iMRI之间的协同作用和差异。我们根据系统性综述和荟萃分析的首选报告项目（PRISMA）声明进行和报告。在排除非相关文献后，对16篇文献进行了评价并纳入定性分析，包括2篇（n = 2）文献综述，1篇（n = 1）书籍章节和13篇（n = 13）临床文献。ALA诱导的荧光超出钆对比增强的边界。一些研究强调了两种工具之间的协同作用，从而增加了切除范围。我们指出这两种方法相结合的优点。然而，iMRI并不广泛可用，价格昂贵，并且不推荐作为高级别胶质瘤的唯一切除控制工具。对于这些中心，FGS与标测和监测技术、神经导航以及术中超声（必要时）一起为实现高级别胶质瘤的最先进大体全切除术提供了良好的环境。
Malignant glioma surgery involves the challenge of preserving the neurological status of patients harboring these lesions while pursuing a maximal tumor resection, which is correlated with overall and progression-free survival. Presently, several tools exist for assisting neurosurgeons in visualizing malignant tissue. Fluorescence-guided surgery (FGS) with 5-aminolevulinic acid (5-ALA) has increasingly been used during the last decade for identifying malignant glioma. Intraoperative magnetic resonance imaging (iMRI), first introduced in the mid-1990s, is being evaluated as a further tool to maximize the extent of resection. We aimed to evaluate the literature and discuss synergies and differences between FGS with 5-ALA and iMRI. We conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. After excluding non-relevant articles, 16 articles were evaluated and included in the qualitative analysis, comprising 2 (n = 2) reviews of the literatures, 1 (n = 1) book chapter, and 13 (n = 13) clinical articles. ALA-induced fluorescence goes beyond the borders of gadolinium contrast enhancement. Several studies stress the synergy between both tools, enabling increase in extent of resection. We point out advantages of combining both methods. iMRI, however, is not widely available, is expensive, and is not recommended as sole resection control tool in high-grade glioma. For these centers, FGS together with mapping and monitoring techniques, neuronavigation and, when needed, intraoperative ultrasound provides an excellent setting for achieving state-of-the-art gross total resection of high-grade gliomas.
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影响因子：
3.7
作者：
Coburger J;Hagel V;Wirtz CR;König R
通讯作者：
König R
影响因子：
4.1
作者：
Chang EF;Clark A;Smith JS;Polley MY;Chang SM;Barbaro NM;Parsa AT;McDermott MW;Berger MS
通讯作者：
Berger MS
影响因子：
4.8
作者：
Aldave, Guillermo;Tejada, Sonia;Diez-Valle, Ricardo
通讯作者：
Diez-Valle, Ricardo
影响因子：
6.2
作者：
Claus, EB;Horlacher, A;Black, PM
通讯作者：
Black, PM
影响因子：
2.3
作者：
Angel Idoate, Miguel;Diez Valle, Ricardo;Tejada, Sonia
通讯作者：
Tejada, Sonia