• World Neurosurg · Aug 2024

    Review

    Utility of Sodium Fluorescein During Peripheral Nerve Tumor Surgery: A Scoping Review of Indications, Techniques, and Outcomes.

    • Mohamed Z Asfour, Carmelo Venero, Jonathan Mo, Clayton Gerndt, Mayur Sharma, Norberto Andaluz, Afnan M Sami, Kiarash Shahlaie, and Paolo Palmisciano.
    • Department of Neurosurgery, Nasser Institute for Research and Treatment Hospital, Cairo, Egypt.
    • World Neurosurg. 2024 Aug 26.

    ObjectiveThe 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.MethodsPubMed, 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.ResultsA 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.ConclusionsSodium 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.Copyright © 2024 Elsevier Inc. All rights reserved.

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