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Erschienen in: Acta Neurochirurgica 12/2014

01.12.2014 | Clinical Article - Brain Tumors

Perioperative microdialysis in meningioma surgery: correlation of cerebral metabolites with clinical outcome

verfasst von: Christina Balaka, George Stranjalis, Theodosis Kalamatianos, Christos Koutsarnakis, Triantafyllos Bouras, Efstathios Boviatsis, Damianos E. Sakas

Erschienen in: Acta Neurochirurgica | Ausgabe 12/2014

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Abstract

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.

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].

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.
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Metadaten
Titel
Perioperative microdialysis in meningioma surgery: correlation of cerebral metabolites with clinical outcome
verfasst von
Christina Balaka
George Stranjalis
Theodosis Kalamatianos
Christos Koutsarnakis
Triantafyllos Bouras
Efstathios Boviatsis
Damianos E. Sakas
Publikationsdatum
01.12.2014
Verlag
Springer Vienna
Erschienen in
Acta Neurochirurgica / Ausgabe 12/2014
Print ISSN: 0001-6268
Elektronische ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-014-2242-2

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