Asleep-awake-asleep versus hypnosis for low-grade glioma surgery : long term follow-up outcome
Copyright © 2023 Elsevier Masson SAS. All rights reserved..
BACKGROUND: Hypnosis-aided craniotomy is a safe alternative to standard asleep-awake-asleep (AAA) surgery in glioma surgery. The impact of these two anesthetic methods on tumor prognosis has never been assessed.
OBJECTIVE: This study aimed to evaluate the possible impact of the type of sedation (i.e., hypnosedation vs. standard sedation) on postoperative outcomes in awake surgery for gliomas.
METHODS: Adult patients who underwent awake surgery for a diffuse glioma, excluding glioblastomas, between May 2011 and December 2019 at the authors' institution were included in the analysis. Pearson Chi-square, Fisher exact, and Mann-Whitney U tests were used for inferential analyses.
RESULTS: Sixty-one (61) patients were included, thirty-one were female (50.8 %), and the mean age was 41.8 years (SD = 11.88). Most patients had IDH mutated tumors (n = 51; 83.6%). Twenty-six patients (42.6%) were hypnosedated while 35 (57.4%) received standard AAA procedure. The overall median follow-up time was 48 months (range: 10 months-120 months). Our results did not identify any significant difference between both techniques in terms of extent of resection (sub-total resection >95% rates were 11.48% vs. 8.20%, OR = 2.2, 95% CI = 0.62-8.44; P = 0.34) and of overall survival (87.5% of patients in the AAA surgery group reach 9 years OS vs. 79% in the hypnosis cohort, cHR = 0.85, 95% CI = 0.12-6.04; P = 0.87).
CONCLUSION: Hypnosis for awake craniotomy is rarely proposed although it is a suitable alternative to standard sedation in awake craniotomy for LGGs, with similar results in terms of extent of resection or survival.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:69 |
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| Enthalten in: |
Neuro-Chirurgie - 69(2023), 6 vom: 01. Nov., Seite 101494 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Bankole, Nourou Dine Adeniran [VerfasserIn] |
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| Links: |
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| Themen: |
Awake craniotomy |
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| Anmerkungen: |
Date Completed 07.11.2023 Date Revised 07.11.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.neuchi.2023.101494 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM362115141 |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Elsevier Masson SAS. All rights reserved. | ||
| 520 | |a BACKGROUND: Hypnosis-aided craniotomy is a safe alternative to standard asleep-awake-asleep (AAA) surgery in glioma surgery. The impact of these two anesthetic methods on tumor prognosis has never been assessed | ||
| 520 | |a OBJECTIVE: This study aimed to evaluate the possible impact of the type of sedation (i.e., hypnosedation vs. standard sedation) on postoperative outcomes in awake surgery for gliomas | ||
| 520 | |a METHODS: Adult patients who underwent awake surgery for a diffuse glioma, excluding glioblastomas, between May 2011 and December 2019 at the authors' institution were included in the analysis. Pearson Chi-square, Fisher exact, and Mann-Whitney U tests were used for inferential analyses | ||
| 520 | |a RESULTS: Sixty-one (61) patients were included, thirty-one were female (50.8 %), and the mean age was 41.8 years (SD = 11.88). Most patients had IDH mutated tumors (n = 51; 83.6%). Twenty-six patients (42.6%) were hypnosedated while 35 (57.4%) received standard AAA procedure. The overall median follow-up time was 48 months (range: 10 months-120 months). Our results did not identify any significant difference between both techniques in terms of extent of resection (sub-total resection >95% rates were 11.48% vs. 8.20%, OR = 2.2, 95% CI = 0.62-8.44; P = 0.34) and of overall survival (87.5% of patients in the AAA surgery group reach 9 years OS vs. 79% in the hypnosis cohort, cHR = 0.85, 95% CI = 0.12-6.04; P = 0.87) | ||
| 520 | |a CONCLUSION: Hypnosis for awake craniotomy is rarely proposed although it is a suitable alternative to standard sedation in awake craniotomy for LGGs, with similar results in terms of extent of resection or survival | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Awake craniotomy | |
| 650 | 4 | |a Extent of resection | |
| 650 | 4 | |a Hypnosis | |
| 650 | 4 | |a IDH mutations | |
| 650 | 4 | |a Low-grade glioma | |
| 650 | 4 | |a Overall survival | |
| 650 | 4 | |a Pre-operative volume | |
| 700 | 1 | |a Kanmounye, Ulrick Sidney |e verfasserin |4 aut | |
| 700 | 1 | |a Ouahabi, Abdessamad El |e verfasserin |4 aut | |
| 700 | 1 | |a Zemmoura, Ilyess |e verfasserin |4 aut | |
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