Ablation of intracerebral glial tumors with the application of laser technology guided by ultrasonography and neuronavigationAuthor(s): Cauia Artur* and Timirgaz Valeriu
Background: Since the first use of a laser in human patients with malignant gliomas was reported in 1966 the utility of lasers as a neurosurgical instrument has been researched extensively. This paper describes a laser-assisted surgical technique which has been used so far in patients for a variety of intracranial lesions, under the control of tumor ablation radicalism guided by ultrasonography and neuronavigation.
Materials and Methods: Following MRI image reconstruction we used ultrasound and neuro-navigation to appreciate the operability of the tumor and the outcomes of the resection. Afterwards an open surgery was performed. Then, with the use of PhotoMedex 980-25W diode-laser in clinical practice, 3 methods of laser thermodestruction of intracerebral gliomas are used:
- Laser thermodestruction of the walls of the lodge after traditional microsurgical tumor ablation
- Laser thermodestruction of the tumor with spread in critical areas of the brain (without contact)
- Selective thermodestruction of hypervascularized tumors (hemangioblastoma, hemangiopericytoma).
Also, new research demonstrates the ability of 980-1064 nm laser light to disrupt or break the local blood-brain barrier, which normally protects the brain from toxins and prevents the penetration of chemotherapeutic preparations and, respectively, has limited treatment options for brain cancer patients.
Results: Thirty two brain tumours (primary and secondary) were operated on during 2016-2021 and then performed laser thermodestruction of the borders of the glial tumours. The complication rate probably related to surgery was 1.6%, morbidity 1.6%, mortality 0%.
Conclusion: The modern arsenal of laser technologies used as a complement to traditional neurosurgical instruments under the control of ultrasonography and neuronavigation allows for less manipulation and invasion of normal brain tissue, also allows to ensure a new level of surgical treatment of cerebral gliomas. Laser microsurgical thermodistruction of tumors is the progressive surgical method in neurooncology.