• Doriam Perera Valdivia, Luis Zapata Vega, Edgar Herrera Pérez, Francisco Toledo Cisneros, Lorena Gómez López, Lagree Guzmán Reynoso, Jordi Rumià Arboix, Alberto Di Somma, Joaquim Enseñat Nora, Abel Ferrés Pijoan, and Pedro Roldán Ramos.
• Neurosurgery Service, "Dr Alejandro Dávila Bolaños" Military Hospital, Managua, Nicaragua. Electronic address: pereravaldivia@gmail.com.
• World Neurosurg. 2024 Jul 1; 187: e860e869e860-e869.

ObjectiveDespite the growing acceptance of neuronavigation in the field of neurosurgery, there is limited comparative research with contradictory results. This study aimed to compare the effectiveness (tumor resection rate and survival) and safety (frequency of neurological complications) of surgery for brain gliomas with or without neuronavigation.MethodsThis retrospective cohort study evaluated data obtained from electronic records of patients who underwent surgery for gliomas at Dr. Alejandro Dávila Bolaños Military Hospital and the Clinic Hospital of Barcelona between July 2016 and September 2022. The preoperative and postoperative clinical and radiologic characteristics were analyzed and compared according to the use of neuronavigation.ResultsThis study included 110 patients, of whom 79 underwent surgery with neuronavigation. Neuronavigation increased gross total resection by 57% in patients in whom it was used; gross total resection was performed in 56% of patients who underwent surgery with neuronavigation as compared with 35.5% in those who underwent surgery without neuronavigation (risk ratio [RR], 1.57; P=0.056). The incidence of postoperative neurologic deficits (transient and permanent) decreased by 79% with the use of neuronavigation, (12% vs. 33.3%; RR, 0.21; P=0.0003). Neuronavigation improved survival in patients with grade IV gliomas (15 months vs. 13.8 months), but it was not statistically significant (odds ratio (OR), 0.19; P=0.13).ConclusionsNeuronavigation improved the effectiveness (greater gross total resection of tumors) and safety (fewer neurological deficits) of brain glioma surgery. However, neuronavigation does not significantly influence the survival of patients with grade IV gliomas.Copyright © 2024 Elsevier Inc. All rights reserved.

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