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Awake surgery for glioma resection during pregnancy: a systematic review

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Abstract

Brain tumors are rarely present during pregnancy. However, they can severely impact the fetus and mother’s well-being due to a complex interaction of disease and physiological factors. Moreover, awake surgery for gliomas has been scarcely reported during this life stage, and the nuances and techniques merit further investigation. Herein, we performed a systematic review of the literature about awake surgery for glioma resection during pregnancy. A total of six patients with a median age of 30.5 years (interquartile range: 40–27) were analyzed. Awake surgery was performed in the third trimester in 50% of patients (median time: 24.5 weeks) without reported intraoperative complications. Conscious sedation was achieved by remifentanil and propofol infusion in 67% of cases, and intraoperative fetal heart monitoring was utilized in 83% of cases. Most studies revealed good clinical maternal-fetal outcomes at follow-up; however, long-term safety effects remain undetermined and warrant further research. In conclusion, awake surgery for glioma resection under a multidisciplinary approach can be a reasonable treatment option for select patients during pregnancy.

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Authors and Affiliations

  1. School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru

    Jhon E. Bocanegra-Becerra, Nicole M. Castillo-Huerta & Alonso Ludeña-Esquivel

  2. Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil

    Sávio Batista, Fernando Costa Vieitas & Rafael Takahashi

  3. Faculty of Medicine, State University of Ponta Grossa, Paraná, Brazil

    Leonardo de Barros Oliveira

  4. Department of Neurosurgery, University of São Paulo, São Paulo, Brazil

    Raphael Bertani

Authors
  1. Jhon E. Bocanegra-Becerra
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  2. Sávio Batista
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  3. Fernando Costa Vieitas
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  4. Rafael Takahashi
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  5. Leonardo de Barros Oliveira
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  6. Nicole M. Castillo-Huerta
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  7. Alonso Ludeña-Esquivel
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  8. Raphael Bertani
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Contributions

J. E. B. B., S. B., F. C. V., and R. T. reviewed the literature following the PRISMA guidelines.

J. E. B. B, S. B., N. M. C. H, A. L. E, L. D. O., and R. B. performed the descriptive statistical analysis, wrote the manuscript, and prepared Fig. 1 and Tables 1 and 2.

All authors reviewed the manuscript.

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Correspondence to Jhon E. Bocanegra-Becerra.

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Bocanegra-Becerra, J.E., Batista, S., Costa Vieitas, F. et al. Awake surgery for glioma resection during pregnancy: a systematic review. Neurosurg Rev 46, 228 (2023). https://doi.org/10.1007/s10143-023-02135-9

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