Rationale for Aggressive Resection and General Surgical Principles for Intracranial Gliomas.

摘要: Given the infiltrative nature of gliomas, controversy has long persisted over value their aggressive surgical removal. Nevertheless, in recent decades, balance opinion neurosurgical oncology shifted from a more nihilistic view that led to many patients' receiving stereotactic biopsy or very limited debulking lesions for tissue diagnosis only, extensive tumor resections which relieve mass effect, lower intracranial pressure, reduce accompanying brain edema, and attenuate dependence on steroids. Achieving clinically significant cytoreduction makes adjuvant therapy successful, ultimately helps preserve improve neurological function. Moreover, increased extent removal results prolongation progression-free survival overall patients improves quality life. The beneficial effect high resection rate may be noted even selected cases recurrent neoplasms. However, optimizing an strategy gliomas requires specific skills, availability advanced intraoperative technological modalities, presence highly qualified multidisciplinary team medical professionals pre-, intra-, postoperative care such patients.