Titre :

Minimally invasive surgery for intradural spinal meningioma: a new standard? A comparative study between minimally invasive and open approaches.

Auteur(s) :

Dauleac, C. [Auteur]
Université Claude Bernard Lyon 1 [UCBL]
Hôpital neurologique et neurochirurgical Pierre Wertheimer [CHU - HCL]
Leroy, Henri-Arthur [Auteur]
Thérapies Assistées par Lasers et Immunothérapies pour l'Oncologie - U 1189 [OncoThAI]
Karnoub, Melodie-Anne [Auteur]
Protéomique, Réponse Inflammatoire, Spectrométrie de Masse (PRISM) - U 1192 [PRISM]
Obled, L. [Auteur]
Hôpital Roger Salengro [Lille]
Mertens, P. [Auteur]
Hôpital neurologique et neurochirurgical Pierre Wertheimer [CHU - HCL]
Assaker, Richard [Auteur]
Protéomique, Réponse Inflammatoire, Spectrométrie de Masse (PRISM) - U 1192 [PRISM]

Titre de la revue :

Neurochirurgie

Éditeur :

Elsevier Masson

Date de publication :

2022-02-09

ISSN :

0028-3770

Mot(s)-clé(s) en anglais :

Meningioma
Spinal cord
Minimally invasive surgery

Discipline(s) HAL :

Sciences du Vivant [q-bio]

Résumé en anglais : [en]

BackgroundSome authors used minimally invasive surgery (MIS) in the treatment of spinal cord tumor, but these studies had a small sample sizes and mixed extra- and intra-medullary tumors, resulting in confounding biases. ...
Lire la suite >BackgroundSome authors used minimally invasive surgery (MIS) in the treatment of spinal cord tumor, but these studies had a small sample sizes and mixed extra- and intra-medullary tumors, resulting in confounding biases. The objectives of the present study were to evaluate the effectiveness and safety of MIS for spinal meningioma resection in comparison with open surgery (OS).MethodsConsecutive patients with spinal meningioma who received either MIS or OS were included. Data for extent of resection, functional outcome, postoperative morbidity and recurrence were collected.ResultsA total of 48 patients (with 51 spinal meningiomas) were included. Eighteen underwent MIS and 30 OS. Meningioma volume and location did not differ significantly between groups: tumors were predominantly thoracic (n = 39, 76.5%) and voluminous (occupying more than 50% of the spinal canal: n = 43, 84.3%). In the MIS group, patients were older (mean age: 66.5 vs. 56.4 years, P = 0.02) and more fragile (mean ASA score: 2.0 vs. 1.6, P = 0.06). In the MIS group, the surgical procedure was shorter (mean duration: 2.07 vs. 2.56 h, P = 0.04), blood loss lower (mean: 252 vs. 456 mL, P = 0.02), and hospital stay shorter (mean: 6.6 vs. 8.1 days). Surgery improved the modified McCormick scale (P < 0.0001) irrespective of the surgical technique. MIS led to no significant differences in extent of resection or postoperative morbidity. Mean follow-up was 46.6 months. At last follow-up, 91.7% (n = 44) of patients were free of progression; all cases of tumor progression (n = 4) occurred in the OS group.ConclusionsMIS outperformed OS in the management of intradural spinal meningioma, irrespective of location and volume. MIS appears to be particularly suitable for elderly and fragile patients.Lire moins >

Langue :

Français

Vulgarisation :

Non

Collections :

• Thérapies Lasers Assistées par l'Image pour l'Oncologie (ONCO-THAI) - U1189

Source :

Harvested from HAL