The Impacts of Intraoperative Ultrasonography Use on Revision Rate in Cases of Brain Tumor

Abstract

Aim: Intraoperative ultrasonography is an accessible and cost-effective monitoring technique that provides a simultaneous view with minimum risk. Despite these advantages, it is still not in use. This study aimed to identify whether the ultrasonography technique would be advantageous for both surgeons in the preoperative period and patient in the postoperative period in cases where intraoperative ultrasonography was used. Materials and Methods:This retrospective study included data of the cases (n=113) diagnosed with a brain tumor in Tekirdağ Namık Kemal University Hospital between January 01, 2015 and December 31, 2020. The cases operated without using ultrasonography (n=38) formed the control group (group 1), while the cases operated by using ultrasonography (n=75) formed the study group (group 2). In all cases selected randomly, the amount of bleeding during the operation, length of the operation and postoperative stay in the hospital, and residue tumor amount were compared. Data obtained were evaluated statistically. The results were presented in mean±standard deviation and/or percentage (frequency). The alpha significance value was accepted as <0.05 in intergroup comparisons of the data obtained by being evaluated in the 95% confidence interval. Results:The average age of the cases in group 1 was 56.7±139 years while it was 57.7±13.2 in group 2. In intergroup comparisons, there was no statistically significant difference (p>0.05) between age (p=0.61), gender (p=0.74), and size of the tumor (p=0.27). It was observed that the average length of the operations of the cases in group 2 was shorter than that of group 1 (p=0.03), and this result was statistically significant (p<0.05). It was reported that the amount of bleeding of the cases in group 2 was also statistically significant (p<0.05) as against group 1. The gross total resection rate of cases in group 1 was calculated as 73.7% while it was 89.3% in group 2. It was understood that the amount of residue in group 2 compared to group 1 was statistically less (p<0.05) in a significant way (p=0.03). In addition to all these, it was found that the length of stay in group 2, which included cases operated with ultrasonography, was shorter than in group 1, which included cases operated without using ultrasonography (p=0.01). Conclusion:The use of intraoperative ultrasonography helps the surgeon by identifying resection margin and revealing the relationship between surrounding neural and vascular structures, thus increasing surgical safety. At the same time, the use of ultrasonography decreases the length of operation, amount of bleeding, and length of stay in the hospital, and increases gross total resection rates.