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Tumor devascularization by intratumoral ethanol injection during surgery. Technical note

R R Lonser1, J D Heiss, E H Oldfield

  • 1Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland 20892-1414, USA.

Journal of Neurosurgery
|May 12, 1998
PubMed
Summary

Directly injecting ethanol (ETOH) into tumors rapidly reduces vascularity, minimizing bleeding during surgery. This technique enhances tumor visualization and facilitates easier, more effective surgical resection.

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Area of Science:

  • Oncology
  • Interventional Radiology
  • Surgical Oncology

Background:

  • Preoperative tumor devascularization is crucial for reducing intraoperative bleeding.
  • Traditional methods involve selective catheterization and embolization.
  • Percutaneous ethanol infusion for vascular lesions suggested a new approach.

Purpose of the Study:

  • To evaluate the efficacy of direct intratumoral ethanol (ETOH) injection for preoperative tumor devascularization.
  • To assess the impact of ETOH injection on tumor hemostasis and surgical resectability.

Main Methods:

  • Four patients with spinal epidural or cerebellar neoplasms received direct intratumoral ETOH injection.
  • The technique involved careful, incremental injection of small ETOH volumes directly into the tumor.

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  • Tumor vascularity, bleeding, visualization, and resection ease were assessed intraoperatively.

    • Main Results:

    • Intraoperative ETOH perfusion resulted in immediate tumor blanching and devascularization.
    • The procedure enhanced tumor visualization and facilitated resection.
    • Reduced intratumoral bleeding was observed, improving the effectiveness of surgical removal.

    Conclusions:

    • Direct intratumoral ethanol injection is an effective method for rapid tumor devascularization.
    • This technique significantly reduces intraoperative bleeding and improves surgical resection.
    • ETOH injection offers a promising approach to enhance hemostasis and resectability in oncology surgery.