• Mehmet Osman Akçakaya, Burcu Göker, Mustafa Ömür Kasımcan, Mustafa Kemal Hamamcıoğlu, and Talat Kırış.
• Department of Neurosurgery, Liv Hospital, Istanbul, Turkey. Electronic address: moakcakaya@gmail.com.
• World Neurosurg. 2017 Nov 1; 107: 966-973.

ObjectiveTo evaluate the feasibility of sodium fluorescein (Na-Fl)-guided surgery involving the use of the PENTERO 900 surgical microscope equipped with the YELLOW-560 nm filter and low-dose Na-FL (200 mg/2-4 mg/kg) in meningioma surgery.Patients And MethodsThe study included 30 patients with newly diagnosed or recurrent meningiomas who underwent Na-Fl-guided surgery between April 2015 and December 2016. Clinical features, surgical observations, extent of resection, and tumor histopathology were retrospectively analyzed. The Na-Fl enhancement pattern was assessed as "no enhancement," "diffuse homogenous enhancement," or "low heterogeneous enhancement."ResultsThere were 30 meningiomas among the 30 patients. In 25 patients, Na-Fl was used for tumor demarcation, whereas in 5 patients, it was used for videoangiography. In this series, 88% of tumors showed diffuse homogeneous Na-Fl enhancement during the operation. The resection rate of the meningiomas was 87%. In 5 patients, in whom Na-Fl was used for videoangiography, the approach was useful to evaluate Na-Fl-stained vessels for patency and to understand their relationship with the tumor. No adverse events were encountered with regard to Na-Fl use.ConclusionsNa-Fl guidance with the use of the YELLOW-560 filter is safe and effective during meningioma surgery.Copyright © 2017 Elsevier Inc. All rights reserved.

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