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Background <p>Diffuse low grade gliomas (LGGs) are a heterogeneous population of intrinsic brain tumors accounting for about 15% of all glial brain neoplasms in which the natural history is characterized by initially indolent growth with significant tendency for recurrence and malignant transformation. However, early and maximal safe resection is currently the first-line treatment for LGGs, the ideal resection technique has not been clearly defined.</p> Objective <p>The study aimed to evaluate safety and efficacy of circumferential sulcus guided resection (SGR) of LGGs.</p> Patients and methods <p>This study was prospectively conducted on 20 patients subjected to microsurgical circumferential sulcus guided resection of LGGs between May 2023 and May 2025 in the department of Neurosurgery, Tanta university hospitals.</p> Results <p>Twenty patients (12 males and 8 females) with a mean age of 31.65 years, ranging from 14 to 53 years. All (100%) patients suffered from generalized seizures as the main complain. The mean preoperative tumor size was 31.43 cm<sup>3</sup> ranging from 15.21 to 55.84 cm<sup>3</sup> with mean extent of tumor resection was 96.83% ranging from 45.05 to 100%. Only 3 (15%) patients have short-term postoperative neurological complications and no patients at all (0%) developed permanent postoperative neurological complications. 15 (75%) patients had diffuse astrocytoma IDH-mutant, grade 2 and 5 (25%) had oligodendroglioma IDH1-mutant &amp; 1p/19q codeleted, grade 2. All (100%) patients were Engel 1 seizure-free with no recurrence all through the research time.</p> Conclusion <p>LGGs typically exhibit limited infiltration across sulcal boundaries, allowing sulci to serve as natural anatomical landmarks for tumor delineation. The SGR approach exploits this characteristic growth pattern to facilitate surgical precision. According to our findings, SGR is both safe and practical technique for LGG removal, including in eloquent brain areas, and is independently correlated with an increased likelihood of achieving complete tumor resection without worsening neurological morbidity.</p>

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Safety and efficacy of circumferential sulcus guided resection of low-grade gliomas

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月29日

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  • Mohamed Ahmed Mahmoud Abdelaal Hassan,
  • Mohamed Amer Ebrahim Amer,
  • Sherif Elsayed Mohamed Elkheshin,
  • Ahmed Atef Ganna,
  • Essam Abdelhameed,
  • Ahmed Mohamed Balaha

摘要

Background

Diffuse low grade gliomas (LGGs) are a heterogeneous population of intrinsic brain tumors accounting for about 15% of all glial brain neoplasms in which the natural history is characterized by initially indolent growth with significant tendency for recurrence and malignant transformation. However, early and maximal safe resection is currently the first-line treatment for LGGs, the ideal resection technique has not been clearly defined.

Objective

The study aimed to evaluate safety and efficacy of circumferential sulcus guided resection (SGR) of LGGs.

Patients and methods

This study was prospectively conducted on 20 patients subjected to microsurgical circumferential sulcus guided resection of LGGs between May 2023 and May 2025 in the department of Neurosurgery, Tanta university hospitals.

Results

Twenty patients (12 males and 8 females) with a mean age of 31.65 years, ranging from 14 to 53 years. All (100%) patients suffered from generalized seizures as the main complain. The mean preoperative tumor size was 31.43 cm3 ranging from 15.21 to 55.84 cm3 with mean extent of tumor resection was 96.83% ranging from 45.05 to 100%. Only 3 (15%) patients have short-term postoperative neurological complications and no patients at all (0%) developed permanent postoperative neurological complications. 15 (75%) patients had diffuse astrocytoma IDH-mutant, grade 2 and 5 (25%) had oligodendroglioma IDH1-mutant & 1p/19q codeleted, grade 2. All (100%) patients were Engel 1 seizure-free with no recurrence all through the research time.

Conclusion

LGGs typically exhibit limited infiltration across sulcal boundaries, allowing sulci to serve as natural anatomical landmarks for tumor delineation. The SGR approach exploits this characteristic growth pattern to facilitate surgical precision. According to our findings, SGR is both safe and practical technique for LGG removal, including in eloquent brain areas, and is independently correlated with an increased likelihood of achieving complete tumor resection without worsening neurological morbidity.