J Neurosurg Sci
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The traditional principle underlying oncological neurosurgery is to remove a tumor mass displacing the brain in order to increase survival. Recently, advances in connectomics enabled an improved understanding of cerebral processing, and led to a paradigmatic shift in tumor surgery based upon interactions between neurooncology and cognitive neurosciences. First, glioma is not a focal tumor invaginated within the parenchyma but a diffuse neoplastic disease migrating in the brain. ⋯ Indeed, awake mapping with real-time monitoring of sensorimotor, visuospatial, language, executive and behavioral functions allowed an optimization of the onco-functional balance. Third, surgery should not be seen in isolation, but integrated in a global multistep therapeutic management, especially in low-grade gliomas, opening the window to repeat resections thanks to the potential of remapping over years. Such a "cognitive neurooncological surgery" which aims to improve both QoL and survival must become a "connectomal neurosurgery".
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Meta Analysis
Prognostic implications of resection extent for patients with glioblastoma multiforme: a meta-analysis.
Surgery is the primary treatment of glioblastoma multiforme (GBM), and a greater extent of resection (EOR) has been shown to be associated with improved survival. Our objective was to perform a meta-analysis comparing the 1-year overall survival (OS) and 1-year progression-free survival (PFS) of GBM patients who receive total resection, incomplete resection, or biopsy only. ⋯ Total resection of GBM is associated with improved OS and PFS as compared to incomplete resection or biopsy.
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We determined the optimal approach to perform lateral lumbar interbody fusion (LLIF) to treat lumbar degenerative scoliosis (LDS) by comparing the safe zone and psoas muscle on the concave and convex sides. ⋯ The convex retroperitoneal vessels were positioned more anteriorly, whereas the ventral nerve roots lacked significant positional alterations, increasing the convex safe zone and providing optimal disc space access and less psoas muscle injury.