Shevel'ov M. Surgical treatment of brain gliomas with median extension

Dissertation is devoted to the problem of improvement of gliomas with median extension diagnostics and surgical treatment. The research is based on results of diagnostics and surgical treatment at 547 patients with gliomas with median extension, whom were treated in clinic of intracerebral tumors in SI "Institute of neurosurgery named after acad. A.P. Romodanov of Academy of Medical Sciences of Ukraine" from 1997 to 2008; it was 68,2% from the total number of brain gliomas.On the base of obtained data the algorithm of gliomas with median extension surgical treatment tactics was developed, based on complex estimation of clinical-neurological inspection, CT-, MRI- SPEСT-results, and takes into consideration features of surgical tactics, tumor histobiology and it's extension into median structures. The complex estimation of modern methods of neurovisualization and optimization of methods of tumor resection allowed to perform total and subtotal removal, that meant enhanced radicalism in 12,6 and 30,2% supervisions accordingly. Partial removal of the tumor was performed in 258 (47,2%) supervisions.A part of patients with Karnofsky index "60 marks and less" after operation decreased from 65.4 to 19.4%; a part of patients with Karnofsky index "70 marks and more" increased from 34.6 to 80.6% after operation.The researches results, analytical approach to operation planning and it's methodology, based on complex estimation of clinical-diagnostics factors, characterizing gliomas with median extension, allowed to increase effectiveness of surgical treatment and quality of life of patients.