Brain tumor: What do you need to know

Brain Tumor Surgery: What You Need to Know

Knowledge is crucial when it comes to diagnosing and treating brain tumors. The management of this condition heavily relies on brain tumor surgery, making it imperative for patients, their families, and healthcare professionals to comprehend its intricacies. Within this extensive manual, let’s explore with UpSurgeOn the realm of brain tumor surgery, including its definition, various classifications, and the key determinants of its effectiveness.

1. What is Brain Tumor Surgery? 

Brain tumor surgery is an extraordinary medical intervention crafted to eradicate tumors or abnormal growths within the brain. The main goal of this procedure is to extract as much of the tumor as possible while ensuring the brain’s functionality remains intact. This intricate process may involve the opening of the skull, known as craniotomy, to access the tumor and employ specialized tools for its removal. The specific approach and extent of the surgery depend on various factors, such as the size, location, and type of the tumor. To optimize the overall outcome, brain tumor surgery is often accompanied by additional treatments like radiation therapy or chemotherapy.   [13]

2. When to consider brain tumor surgery? 

Brain Tumor detection with Surgical simulator
Brain Tumor detection with UpSurgeOn’s BrainTumorBox and Navigation. Source: UpSurgeOn

Brain tumor surgery is typically considered when a patient has been diagnosed with a brain tumor that requires intervention. The decision to perform brain tumor surgery depends on several factors, including the type, size, location, and grade of the tumor, as well as the patient’s overall health and symptoms. In general, brain tumor surgery may be recommended in the following situations:

  • Symptomatic tumors: Surgery may be performed if the tumor is causing significant symptoms such as seizures, neurological deficits, or increased intracranial pressure.
  • Tumors with a high likelihood of being benign: In cases where the tumor is suspected to be benign or low-grade, surgery may be recommended for complete resection and potential cure.
  • Tumors causing mass effect: If the tumor is causing compression or displacement of surrounding brain structures, surgery may be necessary to relieve the pressure and prevent further damage.
  • Tumors with a high likelihood of being resectable: Some tumors are located in surgically accessible areas of the brain and have well-defined borders, making them more amenable to surgical removal.
  • Tumors requiring tissue diagnosis: In cases where the diagnosis is uncertain or a tissue sample is needed for further evaluation, surgery may be performed to obtain a biopsy or remove the tumor for pathological analysis.

When considering brain tumor surgery, it’s crucial to remember that the decision is tailored to each individual, considering the unique characteristics of the tumor and the overall condition of the patient. multidisciplinary team, including neurosurgeons, oncologists, and other specialists needs to evaluate the case and determine the most appropriate treatment approach. [3 – 5] 

3. Common types of Brain Tumor Surgery 

Footage taken from the Brain and Tumor Dissection course. Source: UpSurgeOn

There are several types of brain tumor surgery, depending on the size, location, and characteristics of the tumor. Some common types include:

  • Craniotomy: The most prevalent form of brain tumor surgery is craniotomy. During this procedure, a skilled surgeon delicately makes an incision in the scalp, allowing them to remove a section of the skull and gain access to the tumor. Once the tumor is exposed, the surgeon skillfully eliminates it or extracts a biopsy for further examination.
  • Awake craniotomy: In certain instances, a remarkable technique known as awake craniotomy may be employed. This ingenious approach enables the surgeon to closely observe brain activity throughout the procedure, especially when dealing with tumors situated in vital regions of the brain. Astonishingly, the patient remains awake, actively participates in tests, and follows instructions while the tumor is skillfully extracted.
  • Brain Tumor Resection: During a brain tumor resection, the primary goal is to eliminate as much of the tumor as feasible while safeguarding the surrounding healthy brain tissue. The amount of tumor removed is determined by various factors, such as the tumor’s position, dimensions, and its closeness to vital brain structures.
  • Endoscopic surgery: During endoscopic surgery, a slender and flexible tube equipped with a camera and surgical tools is employed to delicately extract the tumor. This innovative and less invasive technique is specifically beneficial for brain tumors situated in intricate or inaccessible regions of the brain.
  • Stereotactic biopsy: Using advanced imaging techniques like MRI or CT scans, doctors can perform a stereotactic biopsy. This innovative procedure allows them to accurately navigate a needle to the tumor, extracting a tissue sample for diagnosis. It is particularly beneficial when dealing with tumors located in delicate or hard-to-reach areas of the brain.
  • Laser interstitial thermal therapy (LITT): Using laser energy to heat and eliminate tumor cells, laser interstitial thermal therapy (LITT) is a cutting-edge procedure that requires minimal invasion and can be carried out with the help of real-time MRI guidance. This innovative technique is particularly useful for small or deep-seated tumors. 

It’s crucial to understand that the selection of a surgical approach is influenced by several factors. These factors encompass the tumor’s type, size, location, and characteristics, along with the patient’s overall well-being and unique circumstances. [3] [6] [13].

4. Factors That Determine the Success Rate of Brain Tumor Surgery

The outcome of brain tumor surgery can be influenced by a multitude of factors. These factors encompass:

  • Tumor characteristics: The success of surgery can be influenced by various factors, such as the type, size, location, and grade of the tumor. Certain tumors may be conveniently accessible and can be completely removed with ease, whereas others may be situated in crucial regions of the brain, posing a greater challenge for complete removal.
  • Preoperative condition: The patient’s preoperative health and well-being play a crucial role in determining the outcome of the surgery. Those who are in excellent overall health and have fewer underlying health issues are more likely to experience successful surgery and a smooth recovery.
  • Surgical expertise: The success rate of a procedure can be greatly influenced by the expertise and proficiency of the surgical team involved. Surgeons who possess specialized training and a wealth of experience in brain tumor surgery are more inclined to attain superior outcomes.
  • Adjuvant treatments: After surgery, incorporating radiation therapy or chemotherapy can significantly enhance the success rate, offering a powerful boost to the treatment. By specifically targeting any lingering tumor cells, these additional treatments effectively minimize the chances of a recurrence, ensuring a more favorable outcome.
  • Patient factors: The success rate of a medical procedure can be influenced by various factors unique to each patient. Age, cognitive function, and emotional state are some individual patient factors that can play a significant role. Take, for instance, younger patients who possess sharper cognitive abilities; they tend to have a greater likelihood of undergoing a successful surgery and experiencing a smooth recovery.

The success rate of brain tumor surgery is not a one-size-fits-all scenario. It’s crucial to understand that each patient’s case is different, and various individual factors can impact the outcome. Therefore, a thorough evaluation by a medical team is essential to determining the potential success of surgery. [612] 

Conclusion

In the realm of brain tumor surgery, knowledge holds immense power. Grasping the complexities of this intricate field, familiarizing oneself with the diverse range of procedures at hand, and comprehending the factors that sway the success rate are pivotal for patients and healthcare experts alike. Armed with this invaluable insight, you can confidently navigate your path toward improved patient well-being, making informed choices every step of the way.  UpSurgeOn is your trusted partner on the journey of improving patient outcomes. Our surgical simulation technologies were created with the mission of empowering surgeons to do their mission with confidence, precision and skill. Let’s embark on the journey to explore the transformative power of surgical simulation with UpSurgeOn and stay ahead in the ever-evolving field of surgery!


References: 

  1. Kirkpatrick, D. B. (1984b). The first primary brain-tumor operation. Journal of Neurosurgery, 61(5), 809–813. https://doi.org/10.3171/jns.1984.61.5.0809
  2. Boulton, M., & Bernstein, M. (2008). Outpatient brain tumor surgery: innovation in surgical neurooncology. Journal of Neurosurgery, 108(4), 649–654. https://doi.org/10.3171/jns/2008/108/4/0649
  3. Rivera, M., Norman, S., Sehgal, R., & Juthani, R. (2021). Updates on surgical management and advances for brain tumors. Current Oncology Reports, 23(3). https://doi.org/10.1007/s11912-020-01005-7
  4. Brain tumour surgery in the elderly: a brief reappraisal. (1996, April 1). PubMed. https://pubmed.ncbi.nlm.nih.gov/8769926/
  5. Ziai, W., Varelas, P. N., Zeger, S. L., Mirski, M. A., & Ulatowski, J. A. (2003b). Neurologic intensive care resource use after brain tumor surgery: An analysis of indications and alternative strategies. Critical Care Medicine, 31(12), 2782–2787. https://doi.org/10.1097/01.ccm.0000098860.52812.24
  6. Schiavolin, S., Raggi, A., Scaratti, C., Toppo, C., Silvaggi, F., Sattin, D., Broggi, M., & Ferroli, P. (2020). Outcome prediction in brain tumor surgery: a literature review on the influence of nonmedical factors. Neurosurgical Review, 44(2), 807–819. https://doi.org/10.1007/s10143-020-01289-0
  7. Sivasanker, M., Madhugiri, V. S., Moiyadi, A., Shetty, P., & Subi, T. S. (2018). Surgery for brain metastases: An analysis of outcomes and factors affecting survival. Clinical Neurology and Neurosurgery, 168, 153–162. https://doi.org/10.1016/j.clineuro.2018.03.011
  8. D’Andrea, G., Palombi, L., Minniti, G., Pesce, A., & Marchetti, P. (2017). Brain metastases: surgical treatment and overall survival. World Neurosurgery, 97, 169–177. https://doi.org/10.1016/j.wneu.2016.09.054
  9. [The factors influencing the effectiveness of treatment for brain tumors in children]. (1998). PubMed. https://pubmed.ncbi.nlm.nih.gov/10731965/
  10. De Cresci Braga Montelli, T., Peraçoli, M. T. S., Rogatto, S. R., Kaneno, R., Prado, C. H. B. M. D., & De Medeiros Cardassi Rocha, P. (2011). Genetic and Modifying Factors that Determine the Risk of Brain Tumors. Central Nervous System Agents in Medicinal Chemistry, 11(1), 8–30. https://doi.org/10.2174/187152411794961095
  11. Solheim, O., Jakola, A. S., Gulati, S., & Johannesen, T. B. (2012). Incidence and causes of perioperative mortality after primary surgery for intracranial tumors: a national, population-based study. Journal of Neurosurgery, 116(4), 825–834. https://doi.org/10.3171/2011.12.jns11339
  12. Pietilä, T., Stendel, R., Hassler, W., Heimberger, C., Ramsbacher, J., & Brock, M. (1999). Brain tumor surgery in geriatric patients: a critical analysis in 44 patients over 80 years. Surgical Neurology, 52(3), 259–264. https://doi.org/10.1016/s0090-3019(99)00075-0
  13. Potters, J. W., & Klimek, M. (2018). Local anesthetics for brain tumor resection: current perspectives. Local and Regional Anesthesia, 1-8.

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