Contour-guided brain tumor surgery using a stereotactic navigating microscope

被引:17
作者
Roessler, K
Ungersboeck, K
Czech, T
Aichholzer, M
Dietrich, W
Goerzer, H
Matula, C
Koos, WT
机构
[1] Univ Vienna, Sch Med, Neurosurg Clin, Vienna, Austria
[2] Univ Vienna, Sch Med, Dept Neuroradiol, Vienna, Austria
关键词
MKM system; brain tumor surgery; stereotactic microneurosurgery;
D O I
10.1159/000099899
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
Objective: The benefit of intraoperative radiological data integration in approach planning and resection of brain tumors using a computer navigating microscope (MKM Zeiss) was investigated. Methods: Since February 1995, out of 86 MKM-guided surgical procedures, 53 contour-guided tumor cases (24 females, 29 males, mean age 51.6) including 16 metastasis, 14 glioblastomas, 10 low-grade gliomas, 6 anaplastic gliomas, 3 meningiomas and 4 others were performed. The preoperative planning was based on CT in 42 cases and Magnetic Resonance Tomography (MRT) in 11 cases using skin markers (4-9, mean 6). Neuroradiologically defined tumor contours were transferred into the ocular of the microscope and projected into the operating field during the procedure. Results: The advantages of the system were: (1) preoperative approach planning; (2) minimal, accurate skin incision and craniotomy; (3) intraoperative detection of deep seated lesions or lesion components; (4) determination of lesion boundaries; (5) minimized traumatization in/near eloquent areas, Mean registration accuracy improved from 5.3 mm for the first 10 cases up to 2 mm for the last 18 cases. In glioma surgery, the system provided exact definition of radiologically planned resection borders. In meningioma surgery, it allowed a tailored craniotomy, dura opening and resection, lowering the risk of recurrence. In metastasis surgery, it provided a safe approach to deep and eloquent located lesions, Conclusion: Contour-guided operation planning and resection guidance using the investigated navigating microscope provides additional security to avoid some potential risks in brain tumor surgery.
引用
收藏
页码:33 / 38
页数:6
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