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OBJECTIVE: To report a minimally invasive, nontubular endoscopic technique to resect intraparenchymal brain tumors and assess the feasibility, safety, and surgical resection margins achievable by this novel technique. METHODS: Over a 21-month period, 48 patients underwent 50 consecutive endoscopic intraparenchymal tumor resections. Data on surgical morbidity and mortality and length of stay were collected prospectively. The percentage of surgical resection and residual tumor volumes were calculated using preoperative and postoperative volume computed tomography or magnetic resonance imaging. All tumors were resected through a 2-cm minicraniotomy using a high-definition rigid endoscope with a 30-degree viewing angle. Bimanual resection was performed using standard microsurgical technique. RESULTS: Mean patient age was 53 years. There were 42 supratentorial (19 frontal, 17 temporal, 3 occipital, 1 parietal, and 2 parafalcine) tumors and 8 infratentorial tumors. Mean tumor volume was 41 cm(3). There were 12 metastases, 24 glioblastomas, 4 World Health Organization grade III gliomas, 5 World Health Organization grade I-II gliomas, 3 meningiomas, and 2 hemangioblastomas. On volumetric analysis, the overall mean percent resection was 96%. In 70% of cases, >95% resection was achieved; total resection was achieved in 48% of cases. At 30 days postoperatively, there was 1 new postoperative neurologic deficit; there were no deaths during this period. CONCLUSIONS: Our experience demonstrates that resection of intraparenchymal tumors using a minimally invasive endoscopic technique is technically feasible and safe, achieves good tumor resection margins, and has some potential advantages over a traditional microscopic technique.

Original publication

DOI

10.1016/j.wneu.2014.07.034

Type

Journal article

Journal

World Neurosurg

Publication Date

12/2014

Volume

82

Pages

1198 - 1208

Keywords

Brain tumor, Endoscopy, Intraparenchymal, Minimally invasive, Adult, Aged, Blood Loss, Surgical, Brain Neoplasms, Endoscopy, Feasibility Studies, Female, Humans, Male, Middle Aged, Minimally Invasive Surgical Procedures, Neoplasm Metastasis, Neuroendoscopes, Neuronavigation, Neurosurgical Procedures, Prospective Studies, Treatment Outcome, Young Adult