Effectiveness of neuronavigation in resecting solitary intracerebral contrast-enhancing XXXX : a randomized controlled trial.

@entity1 @entity41 @entity5 @entity1104 @entity204
OBJECT: The goal of this study was to assess the impact of neuronavigation on the cytoreductive treatment of solitary contrast-enhancing @entity5 and outcomes of this treatment in cases in which neuronavigation was preoperatively judged to be redundant. METHODS: The authors conducted a prospective randomized study in which 45 @entity1 , each harboring a solitary contrast-enhancing @entity5 , were randomized for surgery with or without neuronavigation. Peri- and postoperative parameters under investigation included the following: duration of the procedure; surgeon's estimate of the usefulness of neuronavigation; quantification of the extent of resection, determined using magnetic resonance imaging; and the postoperative course, as evaluated by neurological examinations, the @entity1 's quality-of-life self-assessment, application of the Barthel index and the Karnofsky Performance Scale score, and the @entity1 's time of @entity204 . The mean amount of @entity41 tissue was 28.9% for @entity1104 ( @entity1104 ) and 13.8% for surgery involving neuronavigation (SN). The corresponding mean amounts of residual contrast-enhancing @entity5 tissue were 29.2 and 24.4%, respectively. These differences were not significant. Gross-total removal (GTR) was achieved in five @entity1 who underwent @entity1104 and in three who underwent SN. Median survival was significantly shorter in the SN group (5.6 months compared with 9 months, unadjusted hazard ratio = 1.6); however, this difference may be attributable to the coincidental early @entity204 of three @entity1 in the SN group. No discernible important effect on the @entity1 ' 3-month postoperative course was identified. CONCLUSIONS: There is no rationale for the routine use of neuronavigation to improve the extent of @entity5 resection and prognosis in @entity1 harboring a solitary enhancing intracerebral lesion when neuronavigation is not already deemed advantageous because of the size or location of the lesion.
