Evaluation of surgical outcome of giant supratentorial meningiomas

Moawad, Ahmed Mohamed; El-Heeny, Mohamed Abdlehameed; Othman, Mohamed Mohey-eldeen; Darwish, Mohab

doi:10.21608/mjmr.2023.247845.1543

Evaluation of surgical outcome of giant supratentorial meningiomas

Document Type : Original Article

Authors

¹ neurosurgery unit , department of surgery , Faculty of Medicine , Minia university , Minia , Egypt

² Department of neurosurgery, Faculty of medicine, Minia university

³ department of neurosurgery, faculty of medicine, minia university

10.21608/mjmr.2023.247845.1543

Abstract

Background: Giant supratentorial meningiomas are challenging to operate on because of their size, conspicuous vascularity (both facilitating and impeding imaging of various neurovascular systems), and the significant cerebral oedema they cause. In this study, we will use our institution's background in the treatment of large supratentorial meningiomas to assess surgical outcomes for these tumors.

Methods: This study presents a 5-year (Jan 2018-Jan 2023) retrospective study of 40 patients with histologically confirmed meningioma ( more than 5 cm in diameter) who had surgical excision at Minia University hospital. Data was gathered about the patient's initial presentation, imaging, surgical approach, complications that arose, and the patient's follow-up status.

Results: 32 females and 8 males participated in the study. average age 44. Average time to follow-up was 36 months. The goal of treatment was complete gross removal of the tumor, which was achieved using a variety of approaches depending on site of lesion. In 95% of cases (38 cases), complete excision of the mass was achieve. In four cases, the tumor recurred. There were no intraoperative deaths recorded while 2 cases died postoperatively.

Conclusion: Radical surgical excision is the primary and best approach for managing giant intracranial supratentorial meningioma. Although young age, surgical procedures, good localization, attempting to reduce operating duration, and Simpson grade all help, large size can make surgery challenging. In order to reduce the risk of complications during surgery, such as pulmonary embolism (PE) and postoperative hematoma in the tumor bed, interdisciplinary collaboration is crucial.

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