Abstract
Purpose
We report the usefulness of intraoperative sodium fluorescein (SF) in the surgical treatment of relapsed high-grade brain tumors in pediatric neurosurgery.
Methods
We describe our protocol for intraoperative SF and three cases of patients between 5 and 11 years diagnosed and surgically treated for relapsed high-grade brain tumors using SF.
Results
The 560-nm microscope filter enables the use of low doses of this fluorochrome. A dose of 3 mg/kg of patient weight of 10% SF, administered intravenously, is safe and effective in children. The effect of SF was immediate, providing a clear margin between the tumor and healthy tissue, which enabled good tumor resection. We observed no adverse effects in the postoperative period, and the patients evolved satisfactorily.
Conclusions
To the best of our knowledge, we describe for the first time the use of fluorescein in reoperations of relapsed high-grade brain tumors in childhood with promising results. Using SF in children is a safe, affordable, and effective technique that offers an excellent intraoperative image, being a feasible option to improve oncological resection. This study is one of the few that uses SF in pediatric neurosurgery, where it could be very beneficial.
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Funding
This work is supported by the Servicio Aragonés de Salud.
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P. A. compiled the clinical data and wrote the main manuscript text. A. A. contributed to the concept and design, and clinical data supervision. S. V. and L. B. L. compiled clinical data. D. F., J. M., and L. G. contributed to the critical revision of the manuscript. J. O. contributed to the concept, design, supervision, and critical revision of the manuscript. All authors reviewed and approved the manuscript.
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We reviewed the patients’ medical records according to our hospital’s confidentiality protocol and followed the protocol for the intraoperative use of SF approved by the hospital’s review board (ID. PROTOCOLO, Z2-948–21, Comisión de Tecnología, Sector Zaragoza 2, Servicio Aragonés de Salud). Informed consent was given by the parents or guardians.
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Alcazar, P., Avedillo, A., Vazquez, S. et al. The usefulness of intraoperative sodium fluorescein in the surgical treatment of relapsed high-grade brain tumors in pediatric patients. Childs Nerv Syst 39, 1501–1507 (2023). https://doi.org/10.1007/s00381-023-05930-3
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DOI: https://doi.org/10.1007/s00381-023-05930-3