Surgery of Cerebral Gliomas: State of the Art
Generally, the first therapeutic approach in patients with cerebral gliomas is surgery. Technological advancements in both diagnosis and surgical instruments which have taken place in the past 20 years have greatly modified surgeons’ attitudes which have become more aggressive against this type of pathology. To define the state of the art in this field, the authors have taken into consideration the surgical cases at the Neurosurgical Institute of the University of Pavia from 1973 to 1989. During this period 339 adult supratentorial gliomas (125 glioblastomas, 115 anaplastic astrocytomas, 74 astrocytomas, and 25 other histotypes) were operated on. Patients were aged between 16 and 76 years. The overall surgical mortality was 4.7% which has decreased from 7% before 1980 to about 2% in the last ten years. Morbidity was 27.2% and has decreased significantly during the same period. The authors discuss pre- and postoperative pharmacological strategies, the usefulness of applying new diagnostic and surgical technology, the incidence of mortality and morbidity, time and quality of survival with respect to the different types of surgical operations.
KeywordsMalignant Glioma Anaplastic Astrocytoma Gross Total Resection Stereotactic Biopsy Cerebral Glioma
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