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Published on: February 29, 2020
The application of fluorescein sodium for the resection of medulloblastoma
Zheng-He Chen1,2,3, Xiang-Heng Zhang1,2,3, Fu-Hua Lin1,2,3
1Department of Neurosurgery, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Yuexiu District, Guangzhou, 510060, People's Republic of China.
Introduction:
Surgical resection of medulloblastoma (MB) remains a challenge. At present, a variety of tracers have been used for intraoperative tumor visualization. However, there are few reports on the intraoperative visualization of MB. Hence, we reported our experience of applying fluorescein sodium (FS) in MB surgery.
Methods:
We retrospectively analyzed the clinical information of patients with MB confirmed by surgery and pathology from January 2016 to December 2020 from Sun Yat-sen University Cancer Center. A total of 62 patients were enrolled, of which 27 received intraoperative FS and 35 did not. The intraoperative dose of FS was 3 mg/kg.
Results:
Among the 62 patients, 42 were males, and twenty were females. The age of onset in the FS group was 9.588 ± 7.322, which in the non-fluorescein sodium group was 13.469 ± 10.968, p = 0.198. We did not find significant differences in tumor location, tumor size, tumor resection, tumor histology, and preoperative symptoms (hydrocephalus, headache, vomit, balance disorder) between the groups. There was no significant difference in the postoperative symptoms (hydrocephalus, headache, vomiting, balance disorder, and cerebellar mutism). However, patients in the FS group had a relatively low incidence of balance disorder and cerebellar mutism. There was definite fluorescence of tumor in all cases of the FS group, and even the tiny metastatic lesion was visible. No case had side effects related to the use of FS.
Conclusions:
FS is safe and effective in MB surgery. Whether the application of FS for surgery can reduce complications remains to be studied in the future.
Insights
Fluorescein sodium (FS) safely and effectively aids in medulloblastoma (MB) surgery by improving intraoperative tumor visualization. Further studies are needed to confirm if FS reduces surgical complications.
Area of Science:
- Neurosurgery
- Oncology
- Medical Imaging
Background:
- Surgical resection of medulloblastoma (MB) presents challenges in intraoperative visualization.
- Limited reports exist on intraoperative visualization techniques specifically for MB.
- Fluorescein sodium (FS) is explored as a potential tracer for enhancing MB tumor visibility during surgery.
Purpose of the Study:
- To evaluate the safety and efficacy of fluorescein sodium (FS) for intraoperative visualization in medulloblastoma (MB) surgery.
- To assess the impact of FS on tumor resection and postoperative outcomes.
Main Methods:
- Retrospective analysis of 62 medulloblastoma patients from January 2016 to December 2020.
- Comparison between 27 patients who received intraoperative FS (3 mg/kg) and 35 who did not.
- Clinical information, tumor characteristics, and postoperative symptoms were analyzed.
Main Results:
- All patients receiving FS showed definite tumor fluorescence, including tiny metastatic lesions.
- No significant differences in tumor location, size, resection, histology, or preoperative symptoms were observed between groups.
- The FS group showed a trend towards lower incidence of postoperative balance disorder and cerebellar mutism, with no reported side effects.
Conclusions:
- Fluorescein sodium (FS) is a safe and effective agent for intraoperative visualization in medulloblastoma surgery.
- Further research is warranted to determine if FS application can decrease postoperative complications.
