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Peripheral Nerve Rapid Fire Abstract

Peripheral Nerve

Sodium Fluorescein-Assisted Peripheral Nerve Sheath Tumors Resection – A Comprehensive Systematic Review and Single-Arm Meta-Analysis

Saturday, May 4, 2024
2:28 PM – 2:32 PM CT
Location:  S405a
Disclosure(s):
Marcio Yuri Ferreira, MD: No financial relationships to disclose
MARCELO P. Porto Sousa: No financial relationships to disclose
Introduction: The treatment of peripheral nerve sheath tumors (PNSTs) is based on surgical excision and the primary goal is to improve symptoms, whilst preserving neurological function. In order to improve this technique, surgeons may use sodium fluorescein (SF) to help visualize the neoplasm and, consequently, facilitate its removal. Aiming to assess the efficacy of this emerging surgical strategy, we conducted a systematic review and single-arm meta-analysis.

Methods: We conducted a systematic search on the PubMed, Embase and Web of Science databases, following the PRISMA guidelines. Studies without outcomes of interest, case series with less than four patients, letters, comments, technical notes, reviews and basic research papers were excluded. The outcomes considered for this study were: number of tumors that achieved total resection, subtotal resection or near total resection, the approach/technique utilized by the surgeon, SF-related complications and total complications.

Results: The literature search comprised 223 articles, even though only five studies, with a total of 175 individuals, were included in our survey. Notably, 70% of the neoplasms presented by the patients were schwannomas. We found a proportion of 88% (95% CI: 76% - 100%) in total resection, 0% (95% CI: 0% - 1%) in near total resection and 7% (95% CI: 0% - 15%) in subtotal resection, all linked to an amount of 179 analyzed PNSTs. Furthermore, a proportion of 1% (95% CI: 0% - 2%) in SF-related complications was spotted among 175 patients. Finally, total complications analysis accounted for 11% (95% CI: 0% - 25%) among 175 individuals.

Conclusion : We concluded that SF-assisted resection of PNSTs is a suitable and relatively safe technique, linked to minimum complications, of which the majority was not associated with the chemical compound itself. Future research is necessary to increase the number of patients available in the current literature and, therefore, enhance future analyses.