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Ultrasonographic intraoperative navigation in surgical treatment of intracerebral tumors


Author: Galearschi Vasile
Degree:doctor of medicine
Speciality: 14.00.28 - Neurosurgery
Year:2012
Scientific adviser: Grigore Zapuhlih
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Institution: State University of Medicine and Pharmacy "Nicolae Testemitanu"

Status

The thesis was presented on the 21 March, 2012
Approved by NCAA on the 23 May, 2012

Abstract

Adobe PDF document0.87 Mb / in romanian

Keywords

intraoperative navigation, ultrasonography, cerebral tumor, surgical treatment, postoperative complications

Summary

Thesis includes 150 text pages and is structured as follows: introduction, 4 chapters, discussions, conclusions and practical recommendations, bibliography made up of 257 titles, 6 annexes, 46 pictures, 39 tables and 9 formulas. The obtained results have been covered in 10 scientific works.

Field of research: neurosurgery, 14.00.28.

Aim of research: improving the surgical treatment results of the patients with different localization and histology brain tumors by using intraoperative ultrasonography.

Thesis goals: To perform a comparative analysis of CT, MRI and IOUS data; evaluation of self-descriptiveness of the IOUS as a method that in real-time can localize the tumor, show the relationship of it with normal anatomic structures, and help to choose an optimal transcortical approach; evaluation of self-descriptiveness of the IOUS in determining the degree of tumor removal; estimation of early results of surgical treatment depending on the tactic and techniques applied; appreciation of effectiveness of the IOUS in decreasing the surgical injury to the brain parenchyma.

The scientific novelty and originality: A research oriented to determine the effectiveness of intraoperative ultrasonography for optimizing the surgical treatment of patients with cerebral tumors was performed.

Scientific issue solved: Surgical treatment of patients with intracerebral tumors, especially of those located in functional regions was optimized using the intraoperative ultrasound at the stage of choosing the surgical approach to the tumor, using microscope during resection and estimating the resection grade (visual, ultrosonographic and histologic).

Theoretical significance of research: Being commensurable with internationally accepted management of brain tumors, our results supplement the theoretical principles of intraoperative navigation. Nowadays, definition and prevention of difficulties, errors, complications in dealing with cerebral tumors is important.

The applicative value of the research: Elaboration of a step-by-step algorithm of use of ultrasound-based navigation that allows to localize the tumor, to see its relationship with surrounding structures, to select an optimal approach and to verify the surgical radicalism, all of them in real-time.

Practical implementation in the INN and ISRHMCh has led to a decreased rate of postoperative complications in brain tumor surgery. The main concepts of using IOUS are implimented into the training program of the chair of neurosurgery of the State University of Medicine and Pharmacy „Nicolae Testemiţanu”.