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Full-Text Articles in Medicine and Health Sciences
Role Of 5-Ala In Improving Extent Of Tumour Resection In Patients With Glioblastoma Multiforme, Muhammad Waqas, Inamullah Khan, Muhammad Shahzad Shamim
Role Of 5-Ala In Improving Extent Of Tumour Resection In Patients With Glioblastoma Multiforme, Muhammad Waqas, Inamullah Khan, Muhammad Shahzad Shamim
Section of Neurosurgery
Goal of surgery for patients with Glioblastoma Multiforme (GBM) is gross total resection with no new neurological deficits. Surgical resection is often restricted due the difficulty in differentiating the tumour from surrounding normal brain using either naked eye, or standard intra-operative white light microscopy. GBM uptakes orally administered 5-ALA becomes fluorescent when viewed by a special light, and this property has been used to improve intra-operative tumour identification. This technique should therefore allow better extent of tumour resection. The hypothesis has been tested through several studies and even though most studies are of low quality, they strongly favour the use …
Role Of Intra-Operative Mri (Imri) In Improving Extent Of Resection And Survival In Patients With Glioblastoma Multiforme, Inamullah Khan, Muhammad Waqas, Muhammad Shahzad Shamim
Role Of Intra-Operative Mri (Imri) In Improving Extent Of Resection And Survival In Patients With Glioblastoma Multiforme, Inamullah Khan, Muhammad Waqas, Muhammad Shahzad Shamim
Section of Neurosurgery
Multiple intraoperative aids have been introduced to improve the extent of resection (EOR) in Glioblastoma Multiforme (GBM) patients, avoiding any new neurological deficits. Intraoperative MRI (iMRI) has been debated for its utility and cost for nearly two decades in neurosurgical literature. Review of literature suggests improved EOR in GBM patients who underwent iMRI assisted surgical resections leading to higher overall survival (OS) and progression free survival (PFS). iMRI provides real time intraoperative imaging with reasonable quality. Higher risk for new postoperative deficits with increased EOR is not reported in any study using iMRI. The level of evidence regarding prognostic benefits …
Extent Of Resection And Timing Of Surgery In Adult Low Grade Glioma, Farhan A. Mirza, Muhammad Shahzad Shamim
Extent Of Resection And Timing Of Surgery In Adult Low Grade Glioma, Farhan A. Mirza, Muhammad Shahzad Shamim
Section of Neurosurgery
Low grade glioma is a group of WHO grade II tumours including diffuse astrocytoma, oligodendroglioma, and oligoastrocytoma. Strong evidence exists in literature now to support early surgery and higher extent of safe resection in improving outcomes. In this review, we are highlighting some of the important studies done in the last few years specifically addressing timing of surgery and extent of resection.