Introduction: Awake-craniotomies have been shown to maximize the extent of tumor resection while minimizing potential neurological deficits. The goal of this study is to retrospectively analyze outcomes in patients undergoing awake craniotomies tumor resection at our institution.
Methods: All cases of adults undergoing awake-craniotomy from 2013- 2014 by a single surgeon were retrospectively reviewed based on an IRB approved protocol. Information regarding patient age, sex, cancer type, procedure type, location, hospital stay, extent of resection, and postoperative complications were extracted.
Results: 78 patient charts were analyzed. Resected cancer types included metastasis to the brain (44%), glioblastoma (33%), WHO grade III anaplastic astrocytoma (14%), WHO grade II glioma (9%). Over a half of procedures were performed in the frontal lobes, followed by temporal, and occipital locations. The most common indication was for motor cortex and primary somatosensory area lesions followed by speech. One patient had a biopsy and another one had an Ommaya reservoir placement. Extent of resection was gross total for 58% patients, near total- 33%, and partial- 6%. Average hospital stay for the cohort was 1.7days. 74% of patients stayed at the hospital for 1 day or less, 13% stayed 2-3 days, 8% stayed 4-5 days, and only 5% stayed more than 5 days. We noted postoperative complications in the following patients: executive function difficulty (1), confusion (1), seizure (1), motor deficits (1), and incision dehiscence/infection (3).
Conclusions: Our initial experience with awake-surgeries for brain tumor resection demonstrates favorable patient outcomes of short hospital stay, low postoperative complications rate, and excellent tumor resection profile.
Patient Care: Patients with malignant brain tumors have a limited survival. Therefore surgical options that lead to safe resection of tumor with rapid restoration of function are warranted for these patients. Awake resection strategies have multiple benefits as demonstrated in our patient cohort.
Learning Objectives: By the conclusion of the session the participants should
1) Understand the role of awake surgeries in maximum-safe resection of brain tumor.
2) Appreciate the low peri-operative morbidity of awake resections of tumors in eloquent and non-eloquent locations.