Clinical Study Of Low-grade Gliomas Surgery On Screen

Background&Purpose:supratentorial low-grade gliomas is common in cortical or subcortical regions of cerebral hemisphere. Epilepsy is the most common clinical symptoms. Although the majority of secondary epilepsy with supratentorial low-grade gliomas can get some ease after surgery, But many do not achieve ideal goal of seizures control. Therefore, if we can improve surgical skills and position epileptic foci accurately, that we could achieve this ideal goal. On this research, we discuss clinical curative effects on surgical treatment for the supratentorial low-grade gliomas assisted by epilepsy knife, in order to provide some ideal surgical methods for the patients of supratentorial low-grade gliomas merged with epilepsy.Methods:l.we conduct a retrospective study of records of92patients with supratentorial low-grade gliomas received surgery seen at Daping Hospital from2007to2011. Among them,67cases merged with epilepsy are divided into simple resection group and resection and treat epileptic foci group, according to whether provided with accurate localization and monitoring for epileptic foci resection assisted by epilepsy knife before and during the surgery.2. patients have taken an antiepileptic drug at least half a year after operation, according to the clinical onset, EGG results to determine whether to reduct or withdraw. All are followed up for6-51months by means of phone or outpatient service, seizure control in Engel classification standard.3.Comparing two groups with satisfaction rate of epilepsy control and showing the resection extent’s influences on satisfaction rate of epilepsy control.Results:①In this study, compared patients’gender, age, tumor location, seizure types and pathological types in two groups with different methods, show no statistical differences.②Seizure control situation:Ⅰ level in42patients, Ⅱ level in5patients, Ⅲ level in15patients,Ⅳ level in5patients. Ⅰ&Ⅱ level as satisfying control, satisfaction rate was70.1%.③The treatment of epileptic foci by using epilepsy knife monitoring group have better seizure control than those without in both patients with total&sub-total resection and partial resection. The differences are statistically significant(p value<0.05).④In Simple-resection group, comparing total&sub-total resection with partial resection shows statistically significant difference (p value<0.05).Conclusions:1.Epilepsy knife can effectively improve the satisfactory outcomes of seizure control in secondary epilepsy with supratentorial low-grade gliomas.2. The resection extent of supratentorial low-grade gliomas could influence on the prognosis of epilepsy obviously. Background&Purpose:We realize that from the first part of research conclusion that without other auxiliary measures, the resection rate of supratentorial low-grade gliomas is higher, the clinical outcomes of patients with epilepsy is better. But how can we increase the resection rate obviously and without severe complications is a very thorny problem. Although the microsurgery is the first choice of treatment for intracranial tumors now, but has not seen more about clinical evaluation report with microsurgery treatment of the supratentorial low-grade gliomas. Therefore, on this research, we discuss the influence on resection rate and complications of supratentorial low-grade gliomas in different ways of operation and technology, in order to improve surgical skills and enhance clinical treatment level.Methods:we conduct a retrospective study for complete records of92patients with supratentorial low-grade gliomas received surgery seen at Daping Hospital from2007to2011. According to the surgical method, the patients are divided into two groups(microsurgical surgery group and traditional surgery group). Finding out all the extent of tumor resection, according to the postoperative MRI and CT imaging within72hours(Try to reduce the effects of edema with normal brain tissue in tumor boundary determination).It is to evaluate extent of tumor resection on the basis of Zhong-cheng Wang standard. Satisfaction rate of resection and incidence of complications are retrospectively analyzed in two groups.Results:①In this study, compared patients’gender, age, tumor location and pathological types in two groups with different surgical methods, show no statistical differences.②In this study, surgical curative effects of all92patients:Complete response is achieved in56patients(61%), partial response in10patients(11%), minor response in24patients(26%), and no response in2patients(2%).There is no operative mortality, the total effective rate is72%.The microsurgical surgery group:complete response is achieved in43patients(72.8%), partial response in6patients(12.1%), minor response in9patients(15.2%), and no response in1patients(1.7%); The traditional surgery group:complete response is achieved in13patients(39.4%), partial response in4patients(12.1%), minor response in15patients(45.5%), and no response in1patients(3.0%). Comparing the satisfaction rate of resection in two groups, microsurgical surgery group do better than traditional surgery group, the difference is statistically significant(p value<0.05).3. microsurgical surgery group:postoperative complications(Tumor cavity bleeding slightly in2patients, new movement disorders in2patients, recent hypomnesis in1patient). traditional surgery group:postoperative complications(Tumor cavity bleeding slightly in4patients, obvious infarction of operative region in2patients, obvious brain edema in2patients, new movement disorders in2patients, new aphasis in1patients, intracranial infection in1patient). Comparing the postoperative complications in two groups, the difference is statistically significant.(p value<0.05).Conclusions:1.Microsurgical surgery can effectively improve satisfaction rate of resection for supratentorial low-grade gliomas.2.Microsurgical surgery can reduce postoperative complications of supratentorial low-grade gliomas preferably.