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연세대학교 의과대학 Yonsei Medical Journal Yonsei Medical Journal 제56권 제2호
발행연도
2015.1
수록면
388 - 396 (9page)

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Purpose: Although conventional neuro-navigation is a useful tool for image-guidedglioma surgery, there are some limitations, such as brain shift. We introduced our methods using an identifiable marker, a “tailed bullet”, to overcome the limitationof conventional neuro-navigation. A tailed bullet is an identifiable tumor locationmarker that determines the extent of a resection and we have introduced our technique and reviewed the clinical results. Materials and Methods: We have developedand used “tailed bullets” for brain tumor surgery. They were inserted into the brain parenchyma or the tumor itself to help identify the margin of tumor. We retrospectively reviewed surgically resected glioma cases using “tailed bullet”. Total110 gliomas included in this study and it contains WHO grade 2, 3, and 4 gliomawas 14, 36, and 60 cases, respectively. Results: Gross total resection (GTR) was achieved in 71 patients (64.5%), subtotal resection in 36 patients (32.7%), and partial resection in 3 patients (2.7%). The overall survival (OS) duration of grade 3 and 4 gliomas were 20.9 (range, 1.2‒82.4) and 13.6 months (range, 1.4‒173.4), respectively. Extent of resection (GTR), younger age, and higher initial Karnofsky Performance Status (KPS) score were related to longer OS for grade-4 gliomas. There was no significant adverse event directly related to the use of tailed bullets. Conclusion: Considering the limitations of conventional neuro-navigation methods,the tailed bullets could be helpful during glioma resection. We believe this simple method is an easily accessible technique and overcomes the limitation of the brain shift from the conventional neuro-navigation. Further studies are needed to verify the clinical benefits of using tailed bullets.

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