Yinghui Bao, Chief physician from Department of Neurosurgery and his team recently used the newly introduced the world's most advanced pentero900 dual fluorescence microscope to carry out the first case of fluorescein sodium-guided total resection of glioma under the microscope in Renji Hospital. The fluorescent stained tumor can be clearly seen under the microscope, with a clear boundary between the tumor and the normal brain tissue. The tumor was successfully resected along the tumor boundary in 3 hours. After a positive symptomatic treatment, the patient recovered well and had independent body activities, with basic self-care and clear verbal expression. Since the official introduction in March this year, the microscope has been used to complete nearly 100 cases of neural tumors surgeries under the microscope.

 

 According to Professor Xiaohua Zhang, director of Department of Neurosurgery of Renji Hospital, brain gliomas originated from glial cells in the brain and are the most common intracranial tumors, accounting for about 45% of all intracranial tumors. Because of the biological characteristics of invasive growth of gliomas, the boundary between the tumors and normal brain tissue is unclear, bringing difficulties to the operation. So gliomas frequently relapse, their prognosis are very poor, and the treatment is a still globally recognized problem. Therefore, to resect gliomas as much as possible can maximally reduce tumor recurrence rate, and judgment of tumor boundary during the operation is the key to realize total resection.

 Studies confirmed that the total resection rate of gliomas are closely related to recurrence and survival of the patients. Complete resection of the tumor helps to extend the patient's survival. How to confirm the resection range requires a way to find a real-time imaging of tumors. With the popularity of fluorescent microscopes, the photosensitizer can accumulated at high concentration at the tumor site with the blood running. After irradiating the tumor site with specific wavelengths, the malignant tumor can produce fluorescence, and the boundary of the tumor can be determined according to the intensity of the fluorescence. This will improve the removal rate of tumors, while reduce tumor remnants and recurrence. Fluorescein sodium guidance technology can more intuitively show the boundary of tumors, and is easy to operate with high safety and stability, without increasing the operation time and surgical risk. It not only provides real-time help in the surgery to shorten the operation time to improve the tumor's total resection rate of tumors, but provide basis for the latter part of the comprehensive treatment to improve the prognosis of patients and extend the survival time.

 The newly introduced pentero900 dual fluorescence microscope by Renji Hospital is the world's most advanced microscope. In addition to be used in conventional microsurgeries, intravascular fluorescence surgeries (for cerebrovascular surgeries) and tumor fluorescence surgeries (for example gliomas surgeries, in which fluorescein sodium guidance technology can more intuitively display tumor boundary. It needn’t refrigerate, and is easy to operate, with high safety and stability, without increasing the operation time and surgical risk).

 Department of Neurosurgery at Renji Hospital performs total resection of intracranial gliomas through the fluorescein sodium-guided microscopy, to realize the real-time and more intuitive display of tumor boundary. The economical and convenient method helps to shorten the operation time, improve the total resection rate of tumors, and provides a strong guarantee for improving the prognosis of patients for the latter part of the comprehensive treatment to extend the survival time. (Correspondent Yujie Tian / Reporter Huiyun Yuan / Translator Weiwei Zhang)