Wake-up anaesthetic and surgical positioning to remove glioma in the language region

": "What is this?" "It's a horse" In craniotomy, doctors wake up patients from the state of full hemp, and through a period of language communication to accurately locate the patient'stumorand language functional area boundary, and then to maximize the removal oftumorwhile protecting brain function from damage - Beijing TiantanHospitalneurosurgery Jiang Tao, DrZhang Zhong and anesthesiologist Chen Xinzhong and others after years of unremitting efforts to explore the difficult area of brain glioma surgery has made a breakthroughIn the past 3 years, they used wake-up anesthesia target control technology and intraoperative language function monitoring technology to treat a total of 81 cases of patients with the disease, and achieved remarkable resultsThe study, supported by the 11th Five-Year Plan and the Capital Medical Development Research Fund, minimizes the risk of permanent language loss in patients with gliomas after surgeryGlioma itself and normal brain tissue is difficult to distinguish, and language region glioma and language fiber boundary is more difficult to distinguish, cut more easily lose language function, cut lesstumorand easy to relapse, and traditional anatomical positioning surgery can not effectively protect brain functionTherefore, how to improve the surgical effect of glioma in the language area has always been a difficult problem in the field of neurosurgeryJiang Tao, DrZhang Zhong and Chen Xinzhong have been tackling this subject since 2004 They used cortical electrostimulation positioning techniques to remove 81 cases of glioma in the language functional area under wakeful anesthesia, and the total tumor removal rate was 87%, and there was no surgical death Postoperative follow-up showed that, except for a very small number of patients who had moderate or mild language dysfunction for a period of time after surgery, more than 80% of the remaining patients basically guaranteed language function (KPS function evaluation was above 80 points); There were no anaesthetic complications in all the patients According to jiang Tao, the subject leader, this technology determines that the language functional area is accurate, safe and reliable Intraoperative language positioning technology is the core technology of surgery, and intraoperative cortical electrical stimulation is the standard of to determine the function of the language cortex and subcuttical cortex Before surgery, doctors determine the relationship between the patient's language area and the bow beam fibers that make up the language with tumor sorcerable fibers (DTI) technology, and perform a psychological evaluation of the patient's function and other neuro
psychological , and determine the surgical plan; Surgical selection of the forehead or the top of the forehead incision into the road, in the whole hemp down the cranial surgery In the process of using B super-determining the anatomical boundary of the tumor and marking, using the epithelial electroencephalic to check the epilepsy and kill, and then to find the tumor Wake the patient up before removing the tumor, and according to the dialogue between the physician and the patient when the electrostimulation cortex, determine the boundary of the patient's brain's language function, and remove the tumor about 1cm from the nearest edge of the language area, thus greatly improving the quality and effect of the surgery of glioma in the language functional area (Far deep)