Minimally invasive one burr hole endoscopic resection for deep-seated glioblastoma

Résumé fourni par la source

Background Glioblastoma is a highly malignant brain tumor for which maximal safe resection remains essential for treatment. However, deep-seated lesions often require invasive surgery. Herein, we describe the technical feasibility of a one-burr hole endoscopic resection for selected deep-seated glioblastoma cases. Methods Between 2017 and 2025, six patients with glioblastoma underwent burr hole endoscopic tumor resection. Neuronavigation-guided transcortical access was established using a 10-mm transparent sheath. Continuous intraoperative navigation was achieved by registering a ventricular puncture cannula, a transparent sheath, and a suction device in the navigation system. Photodynamic diagnosis (PDD) was applied for tumor visualization. The extent of resection was evaluated by volumetric analysis of the target lesion on pre- and post-operative MRI. Results All procedures were completed through a single burr hole without conversion to conventional craniotomy. The mean operative time was approximately 120 min. The mean extent of resection of the target lesion was 96.9% (range, 89.1–100%). In one patient who received bevacizumab, a progressive non-enhancing FLAIR lesion was successfully resected. Intraoperative orientation and hemostatic control were maintained using navigation-integrated endoscopic techniques and adjunctive hemostatic agents in all cases. One patient developed postoperative hematoma accumulation within the resection cavity; however, reoperation was not required. Conclusions One-burr hole endoscopic resection is a feasible and minimally invasive option for select deep-seated glioblastoma cases. Continuous neuronavigation, PDD assistance, and careful hemostatic strategies are important to ensure safe tumor removal through a narrow operative corridor.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.