Experience with awake throughout craniotomy in tumour surgery: technique and outcomes of a prospective, consecutive case series with patient perception data

Leon-Rojas, Jose; Ekert, Justyna O.; Kirkman, Matthew A.; Sewell, Darreul; Bisdas, Sotirios; Samandouras, George

doi:10.1007/s00701-020-04561-w

Cited by 14 publications

(10 citation statements)

References 52 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Many studies have reported on patient experience of awake craniotomy for tumor resection in Western populations. Collectively, they demonstrated good level of tolerance and acceptance 3–11 . However, data from non‐Western populations are lacking.…”

Section: Discussionmentioning

confidence: 97%

“…Only 57% (20/35) of operations that were performed during the study period were included, mainly due to death or loss to follow‐up. Nevertheless, compared with previous similar studies ( n = 9 to 105), our sample size is considered analogous to theirs 3–11 . Secondly, patients are being asked to recollect their perioperative experience some time (up to 3 years) after the surgery.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Awake craniotomy for brain tumor resection: Patient experience and acceptance in an Asian population

Tan

Jain

Chan

et al. 2022

Asia-Pac J Clncl Oncology

View full text Add to dashboard Cite

Introduction: Awake craniotomy is well-established for resection of brain tumor in the eloquent areas. Previous studies from Western countries have reported good level of patient tolerance and acceptance. However, its acceptability in non-Western populations, with different ethnic, social, cultural, religious, and linguistic backgrounds, has not been studied systematically. This study aims to evaluate the experience of patients from an Asian population who underwent awake craniotomy for tumor resection.Methods: Data on patient experience were collected by interviewing patients using a structured questionnaire at follow-up appointment. Data on patient demographics and diagnosis were collected from medical records.Results: Eighteen patients (age 16-68 years) who underwent 20 awake craniotomies were recruited. Preoperatively, all (100%) patients understood the indication for awake craniotomy. Almost all felt fully counseled by the neurosurgeon (90%), anesthetist (100%), and neuropsychologist (95%). Ninety-five percent reported their family to be supportive of awake craniotomy. Seventy-five percent felt adequately prepared on operation day. Intraoperatively, most patients did not experience pain/discomfort (55%) or anxiety (65%). Nearly all found intraoperative motor and language testing to be easy (100% and 90%, respectively). Postoperatively, 100% were satisfied with their care. One hundred percent rated their overall experience as good or excellent. Eighty percent were willing to undergo awake craniotomy again if indicated. Conclusion:Awake craniotomy is well-accepted in an Asian population. All patients had good-to-excellent overall experience, with most willing to undergo awake craniotomy again. Our findings underscore the generalizability of awake craniotomy across different socio-cultural backgrounds and support its utilization in countries with a significant Asian population.

show abstract

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Awake craniotomy for brain tumor resection: Patient experience and acceptance in an Asian population

Tan

Jain

Chan

et al. 2022

Asia-Pac J Clncl Oncology

View full text Add to dashboard Cite

show abstract

“…148 The patient should be fully informed about the benefits and risks of the procedure because their cooperation is needed, and they should not be significantly distressed by the awake craniotomy. 146,147,149,150 A systematic review showed that the use of awake craniotomy with electrical stimulation during glioma resection is associated with lower risks of long-term neurological and language deficits and a higher extent of glioma resection, leading to shorter hospital stay. 140 Awake surgery is a useful method when the tumor is located in the language-dominant hemisphere.…”

Section: Awake Craniotomymentioning

confidence: 99%

Intraoperative MR Imaging during Glioma Resection

2022

View full text Add to dashboard Cite

One of the major issues in the surgical treatment of gliomas is the concern about maximizing the extent of resection while minimizing neurological impairment. Thus, surgical planning by carefully observing the relationship between the glioma infiltration area and eloquent area of the connecting fibers is crucial. Neurosurgeons usually detect an eloquent area by functional MRI and identify a connecting fiber by diffusion tensor imaging. However, during surgery, the accuracy of neuronavigation can be decreased due to brain shift, but the positional information may be updated by intraoperative MRI and the next steps can be planned accordingly. In addition, various intraoperative modalities may be used to guide surgery, including neurophysiological monitoring that provides real-time information (e.g., awake surgery, motorevoked potentials, and sensory evoked potential); photodynamic diagnosis, which can identify high-grade glioma cells; and other imaging techniques that provide anatomical information during the surgery. In this review, we present the historical and current context of the intraoperative MRI and some related approaches for an audience active in the technical, clinical, and research areas of radiology, as well as mention important aspects regarding safety and types of devices.

show abstract

“…Our awake-throughout craniotomy technique has been described [3]. The patient received a small amount of target-controlled infusion (TCI) of propofol and remifentanil targeting blood concentrations of 0.8-1.2 mg/ml and 1-2 ng/ml, respectively [3]. Following Mayfield clamp application, all TCI was stopped.…”

Section: Anaesthetic Techniquementioning

confidence: 99%

Mapping and anatomo-surgical techniques for SMA-cingulum-corpus callosum gliomas; how I do it

et al. 2021

Self Cite

View full text Add to dashboard Cite

Background Awake brain mapping paradigms are variable, particularly in SMA, and not personalised to each patient. In addition, subpial resections do not offer full protection to vascular injury, as the pia can be easily violated. Methods Mapping paradigms developed by a multidisciplinary brain mapping team. During resection, a combined subpial/interhemispheric approach allowed early identification and arterial skeletonization. Precise anatomo-surgical dissection of the affected cingulum and corpus callosum was achieved. Conclusions In SMA-cingulum-CC tumours, a combined subpial/interhemispheric approach reduces risk of vascular injury allowing precise anatomo-surgical dissections. Knowledge of cognitive functions of affected parcels is likely to offer best outcomes.

show abstract

Experience with awake throughout craniotomy in tumour surgery: technique and outcomes of a prospective, consecutive case series with patient perception data

Cited by 14 publications

References 52 publications

Awake craniotomy for brain tumor resection: Patient experience and acceptance in an Asian population

Awake craniotomy for brain tumor resection: Patient experience and acceptance in an Asian population

Intraoperative MR Imaging during Glioma Resection

Mapping and anatomo-surgical techniques for SMA-cingulum-corpus callosum gliomas; how I do it

Contact Info

Product

Resources

About