{"id":"b667b686-23a7-417e-9ae7-49208f8af15d","slug":"fluorescein-for-resection-of-high-grade-gliomas-a-safety-study-control-in-a-single-center-and-review-of-the-literature","title":"Fluorescein for resection of high-grade gliomas: A safety study control in a single center and review of the literature","authors":["Natale Francaviglia","Domenico Gerardo Iacopino","Gabriele Costantino","Alessandro Villa","Pietro Impallaria","Francesco Meli","Rosario Maugeri"],"abstract":"Background: The importance of a complete resection of high-grade gliomas (HGGs) has been highlighted in scientific literature, in order to limit tumor recurrence and above all to improve disease-free survival rates. Several fluorescent biomarkers have been tested to improve intraoperative identification of residual tumor; 5-aminolevulinic acid (5-ALA) and fluorescein sodium (FS) are now starting to play a central role in glioma surgery. We performed a retrospective analysis on 47 patients operated for HGGs. Here we report our preliminary data. Methods: Data of 47 consecutive patients with HGG have been collected in our study (25 males, 22 females; mean age: 60.3 years, range: 27–86 years). Fluorescein (5 mg/kg of body weight) was injected intravenously right after the induction of general anesthesia. A YELLOW 560 filter was used on an OPMI Pentero 900 microscope (Carl Zeiss Meditec, Oberkochen, Germany) to complete a microsurgical tumor removal. Glioma resection and quality of life were evaluated preoperative and postoperatively. Results: Gross total resection (GTR) was achieved in 53.2% (n = 25) of patients. A subtotal resection (STR) (>95%) was achieved in 29.8% (n = 14), while a partial resection (PR) (n = 8) of patients. Overall, in 83% (n = 39) of patients who underwent fluorescence-guided surgery the resection rate achieved was >95%. No adverse effects correlated to fluorescein have been recorded. Conclusion: Fluorescein seems to be safe and effective in the resection of HGGs, allowing a high rate of gross total removal of contrast enhanced areas.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/b667b686-23a7-417e-9ae7-49208f8af15d/featured/hero-1782420911410.png","publishDate":"2017-07-11T00:00:00.000Z","doi":"10.4103/sni.sni_89_17","categories":["Neuro-oncology","Original Article"],"fullTextUrl":"http://surgicalneurologyint.com/wp-content/uploads/2017/07/8493/SNI-8-145.pdf"}