Περίληψη:
Background: Brain tumour resection requires surgical manoeuvres that may cause an ischaemic injury to peritumoral tissue. The aim of the present study was to examine whether putative alterations in peritumoral tissue biochemistry, monitored by microdialysis, correlate with clinical outcome in patients undergoing craniotomy for meningioma resection.
Methods: In 34 patients undergoing meningioma resection (35 % male; mean age ± SD: 54.3 ± 12.1 years), microdialysis measurements were taken perioperatively from peritumoral brain parenchyma. Standard metabolites (glucose, lactate, pyruvate, glycerol and the lactate:pyruvate ratio) were quantified in relation to clinical outcome assessed by the Glasgow Coma Scale (GCS) and the Karnofsky Performance Status scale.
Conclusions: Postoperative levels of glucose and pyruvate and the lactate:pyruvate ratio appear to correlate with clinical outcome in patients undergoing meningioma resection. The present findings provide support for the utility of microdialysis as a prognostic tool in brain tumour surgery.
Results: Higher postoperative glucose and pyruvate levels were found in patients with a favourable outcome (GCS not deteriorated or Karnofsky score >80). Multiple logistic regression analysis (age, preoperative physical status, metabolite levels as independent variables) showed that lower postoperative glucose and pyruvate levels as well as higher lactate:pyruvate ratio values were independently associated with an unfavourable outcome as defined by Karnofsky score <80 [(OR: 0.084, 95 % CI: 0.01–0.98, p = 0.049), (OR: 0.97, 95 % CI: 0.95–0.99, p = 0.050), (OR: 1.21, 95 % CI: 1.04–1.42, p = 0.015) respectively], as well as with death [(OR: 0.08, 95 % CI: 0.01–0.97, p = 0.046), (OR: 0.94, 95 % CI: 0.89–0.99, p = 0.016), (OR: 1.07, 95 % CI: 1.00–1.15, p = 0.05) respectively]. © 2014, Springer-Verlag Wien.
Συγγραφείς:
Balaka, C.
Stranjalis, G.
Kalamatianos, T.
Koutsarnakis, C.
Bouras, T.
Boviatsis, E.
Sakas, D.E.
Λέξεις-κλειδιά:
dexamethasone; glucose; glycerol; lactic acid; phenytoin; pyruvic acid; valproic acid; glucose; glycerol; lactic acid; pyruvic acid, adult; anticonvulsant therapy; Article; biochemistry; brain level; clinical article; craniotomy; female; Glasgow coma scale; human; human tissue; Karnofsky Performance Status; male; meningioma; microdialysis; observational study; outcome assessment; perioperative period; priority journal; prospective study; aged; brain; Meningeal Neoplasms; meningioma; metabolism; microdialysis; middle aged; postoperative period; treatment outcome, Adult; Aged; Brain; Female; Glasgow Coma Scale; Glucose; Glycerol; Humans; Lactic Acid; Male; Meningeal Neoplasms; Meningioma; Microdialysis; Middle Aged; Postoperative Period; Pyruvic Acid; Treatment Outcome
