Effective Management of Brainstem Tumors: A Study of 22 Patient Experiences.
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AIM: To evaluate the surgical outcomes, extent of resection, and postoperative clinical improvement in 22 patients with brainstem tumors. MATERIAL AND METHODS: We performed surgery on 22 patients with brainstem tumors using various approaches to access the pathology. Our goal was to achieve gross total resection wherever feasible, although this was not possible in all cases. Spontaneous breathing was preferred during surgery, and resection was halted if any disturbance occurred. Bipolar or monopolar coagulation was avoided, and smooth compression and irrigation were used for bleeding control. Neuromonitoring was employed during surgery for all patients. RESULTS: Among the 22 patients included in this study, 4 presented with long tract symptoms, 3 had hydrocephalus, 5 had papillary stasis, 4 had cerebellar findings, 3 had gait disturbances, 1 had respiratory disturbance, and 1 had dysphagia. Gross total resection was achieved in 10 patients, near-total resection in 4, and partial resection in 8. CONCLUSION: Surgery enables histologic diagnosis, relieves mass effect, and improves symptoms in brainstem tumors. While gross total resection is ideal, it should not be insisted on in infiltrative tumors; partial or subtotal resection may provide long-term benefit in focal and exophytic lesions. Careful neuromonitoring and anatomical planning are essential to minimize morbidity.