TY - JOUR
T1 - Utility of Sodium Fluorescein During Peripheral Nerve Tumor Surgery
T2 - A Scoping Review of Indications, Techniques, and Outcomes
AU - Asfour, Mohamed Z.
AU - Venero, Carmelo
AU - Mo, Jonathan
AU - Gerndt, Clayton
AU - Sharma, Mayur
AU - Andaluz, Norberto
AU - Sami, Afnan M.
AU - Shahlaie, Kiarash
AU - Palmisciano, Paolo
N1 - Publisher Copyright:
© 2024 Elsevier Inc.
PY - 2024/11
Y1 - 2024/11
N2 - Objective: The primary treatment for peripheral nerve tumors involves maximal surgical resection while preserving nerve function. Sodium fluorescein shows potential for enhancing the safety and efficacy of nerve tumor surgery. This review evaluates the advantages and limitations of sodium fluorescein in this context. Methods: PubMed, EMBASE, Web-of-Science, and Scopus were searched following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-scoping review guidelines to include studies reporting the use of sodium fluorescein in peripheral nerve tumors surgery. Intervention-related outcomes (i.e., extent of resection, clinical outcomes, complication rates, recurrence rates, and duration of surgery) were evaluated and summarized. Results: A total of 4 studies encompassing 166 patients with 168 tumors were included. Patients were mostly female (98; 53.6%), 101 (69.2%), had sporadic (nonsyndromic) tumors, and at histopathology, 114 (67.9%) tumors were WHO grade-1 schwannomas. Gross total resection was achieved in 146 (86.9%) tumors. Postoperative complications were reported in 16 cases (10.2%%), none related to side effects of the fluorescent dye. High tumor fluorescence was reported in 150 (94.3%) tumors, while absent and low parent nerve fluorescence was reported in 121 (79.6%) and 27 (17.8%), respectively. The median duration of surgery was 51.5 (range: 24–92) minutes. Conclusions: Sodium fluorescein shows promise as assisting tool in nerve tumor surgery by facilitating differentiation among the tumor, parent nerve, and surrounding soft tissue. However, multicenter randomized controlled trials are necessary to determine its effect on extent of resection rates, clinical outcomes, postoperative complication rates, and surgical duration in comparison to current standard of care.
AB - Objective: The primary treatment for peripheral nerve tumors involves maximal surgical resection while preserving nerve function. Sodium fluorescein shows potential for enhancing the safety and efficacy of nerve tumor surgery. This review evaluates the advantages and limitations of sodium fluorescein in this context. Methods: PubMed, EMBASE, Web-of-Science, and Scopus were searched following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-scoping review guidelines to include studies reporting the use of sodium fluorescein in peripheral nerve tumors surgery. Intervention-related outcomes (i.e., extent of resection, clinical outcomes, complication rates, recurrence rates, and duration of surgery) were evaluated and summarized. Results: A total of 4 studies encompassing 166 patients with 168 tumors were included. Patients were mostly female (98; 53.6%), 101 (69.2%), had sporadic (nonsyndromic) tumors, and at histopathology, 114 (67.9%) tumors were WHO grade-1 schwannomas. Gross total resection was achieved in 146 (86.9%) tumors. Postoperative complications were reported in 16 cases (10.2%%), none related to side effects of the fluorescent dye. High tumor fluorescence was reported in 150 (94.3%) tumors, while absent and low parent nerve fluorescence was reported in 121 (79.6%) and 27 (17.8%), respectively. The median duration of surgery was 51.5 (range: 24–92) minutes. Conclusions: Sodium fluorescein shows promise as assisting tool in nerve tumor surgery by facilitating differentiation among the tumor, parent nerve, and surrounding soft tissue. However, multicenter randomized controlled trials are necessary to determine its effect on extent of resection rates, clinical outcomes, postoperative complication rates, and surgical duration in comparison to current standard of care.
KW - Cranial nerve surgery
KW - Intraoperative surgical tools
KW - Nerve tumor surgery
KW - Neuro-oncology
KW - Peripheral nerve surgery
KW - Skull base
KW - Sodium fluorescein
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UR - http://www.scopus.com/inward/citedby.url?scp=85204447430&partnerID=8YFLogxK
U2 - 10.1016/j.wneu.2024.08.101
DO - 10.1016/j.wneu.2024.08.101
M3 - Review article
C2 - 39197705
AN - SCOPUS:85204447430
SN - 1878-8750
VL - 191
SP - 267-277.e1
JO - World neurosurgery
JF - World neurosurgery
ER -