Assessment of Surgical success in benign neoplasms of neural origins using sodium fluorescein as an intraoperative fluorescein technique

The use of sodium fluorescein intraoperatively in benign tumors of the brain and spinal column is still in the process of research and proving. There is not enough
number of studies about its possible positive effect in the world literature. Theoretical knowledge indicates the usefulness of fluorescence techniques in tumors with rapid growth and greater destructiveness of nervous tissue, such as malignant tumors. Here, the accumulation in the pathological tissue allows better differentiation from the healthy brain parenchyma. In the case of benign tumors of
the brain and spinal column, the anatomy allows a clearer d
usefulness of fluorescence techniques is not taken into account. However, the distinction is only one of the many intraoperative problems and challenges that the neurosurgeon faces when removing benign tumors. Some of these issues can be overcome by using fluorescent agents such as sodium fluorescein. In the presented clinical study, conclusions were drawn based on a comparison between a control group of patients operated on without the use of sodium fluorescein and a test group of patients operated on with the use of sodium fluorescein intraoperatively. The surgical success and percentage were based on neurological status postoperatively, control images from magnetic resonance imaging (MRI) and computed tomography (CT) with contrast postoperatively, days of hospital stay, and the number of fatal outcomes and intraoperative notes on the degree of tumor resection. The patients were operated on by the same surgical team over a period of nine years (from 2016 to 2025) in two hospitals. Neurological status was evaluated
during the postoperative stay. Imaging methods were taken during a wide postoperative period starting from the days of hospitalization postoperatively to control examinations several years after the surgical treatment. Days of hospitalization were taken as an indicative measure of postoperative recovery and complications. Only those fatal outcomes that occurred during the postoperative hospital stay were recorded. The intraoperative note on the degree of tumor resection was based on the individual assessment of the neurosurgeon during the surgery performed using microsurgical technique under the Haag Streit and Zeiss
Kinevo 900 operating microscope, using ‘white’ (daylight) and ‘yellow’ (adapted for fluorescent recognition) light with a 560nm filter. After mentioning all above, we came to a conclusion that sodium fluorescein (SF) should be used for benign brain and spine tumors in every possible situation. Although it has no influence on the recurrence rate, it can be used as a helpful adjunct for doubtable situations during
surgery, can increase the operator’s confidence and influences survival rate.