[Stereotaxic microsurgical resection of intracranial tumors guided by imaging and assisted by computer]
L A Ochoa Zaldivar1, B Estupiñán Díaz, G López Flores
1Servicio de Neurocirugía; Centro Internacional de Restauración Neurológica (CIREN), La Habana, 11300, Cuba. ochoa@neuro.sld.cu
Introduction:
The microsurgical techniques for resection of intracranial lesions are limited where anatomical references do not exist or cannot be used as guides in the dissection of deeply located lesions or in more superficial eloquent areas. The stereotaxic guide, guided by imaging gives precise volumetric and geometric definition in intracranial lesions. Its application in the resection of intracranial tumors has special characteristics due to their biological condition and varied localization.
Objectives:
Spatial orientation during surgery is essential. We show this application of stereotaxic surgery in the Centro Internacional de Restauración Neurológica (CIREN) in La Havana, Cuba, between May 1994 and February 1988, describing 65 microsurgical operations done using stereotaxis in 62 patients with intracranial cerebral tumors.
Patients And Methods:
The procedure was divided into three stages: acquiring an image, computerized axial tomography and surgical planning, with the STASSIS planning system and microsurgical procedures, including systems of stereotaxis: Leksell, Micromar and Estereoflex.
Results:
Of the total, 27 of these patients had glial tumors, 33 non-glial tumors and only 2 had non-neoplastic lesions of different sites and sizes. A total of 30 resections were done. Surgical morbidity was minimal and there was no surgical mortality.
Conclusions:
The main advantages of this method are: exact localization of the site for craniotomy, easy spatial orientation and ease in distinguishing the delimitation between the tumour and the healthy tissue. It has been shown that Estereoflex may be used in cerebral microsurgery.
Insights
Stereotactic surgery provides precise guidance for intracranial tumor resection, improving spatial orientation and tumor-to-tissue differentiation. This technique minimizes surgical risks, demonstrating its value in complex neurosurgical cases.
Area of Science:
- Neurosurgery
- Medical Imaging
- Surgical Navigation
Context:
- Microsurgical resection of intracranial lesions is challenging due to limited anatomical landmarks.
- Deeply located or superficial eloquent brain lesions require advanced guidance techniques.
- Stereotactic navigation, guided by imaging, offers precise volumetric and geometric definition for intracranial lesions.
Purpose:
- To evaluate the application of stereotactic surgery for intracranial tumor resection.
- To describe microsurgical operations using stereotaxis in patients with cerebral tumors.
- To assess the efficacy and safety of stereotactic techniques in neurosurgery.
Summary:
- Sixty-two patients with intracranial cerebral tumors underwent 65 microsurgical operations using stereotaxis between 1994 and 1998.
- The procedure involved image acquisition, computerized tomography, and surgical planning using the STASSIS system.
- Microsurgical procedures utilized stereotactic systems including Leksell, Micromar, and Estereoflex.
- The study included 27 glial tumors, 33 non-glial tumors, and 2 non-neoplastic lesions.
- Thirty tumor resections were performed with minimal surgical morbidity and no mortality.
Impact:
- Stereotactic surgery enables exact localization for craniotomy and enhances spatial orientation.
- The technique facilitates clear differentiation between tumor and healthy tissue.
- Estereoflex is confirmed as a viable stereotactic system for cerebral microsurgery.
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