Clinical effectiveness of sodium fluorescein-guided microsurgery in patients with high-grade gliomas

OBJECTIVE: The aim of this study was to assess the clinical effectiveness of sodium fluorescein-guided microsurgery in pa-tients with high-grade gliomas.PATIENTS AND METHODS: 120 patients with high-grade gliomas who were hospitalized in our Neurosurgery Department from January 2018 to January 2021 were selected and then di-vided into a control and a study group using the random number table method, with 60 cases in each group. To compare the clinical efficacy of patients in both groups, neuronavigation micro-surgery was used in the control group and neu-ronavigation microsurgery combined with sodi-um fluorescein-guided microsurgery was used in the study group.RESULTS: The Gross Total Resection Rate (GTRR) of the study group was significantly higher than that of the control group. There was no significant difference in intraoperative bleeding loss or hospital stay between the two groups, and the study group had a much shorter operation time than the control group. The Kar-nofsky Performance Score (KPS) and the Na-tional Institutes of Health Stroke Scale (NIHSS) scores did not significantly differ between the two groups prior to surgery but declined sig-nificantly in the study group compared to the control group following treatment. In terms of adverse effects, there was no significant dif-ference between the two groups. In the con-trol group, the median progression-free surviv-al (PFS) was 7.5 months, and the median over-all survival (OS) was 9.6 months, whereas in the study group, the median PFS was 9.5 months, and the median OS was 11.5 months. PFS did not significantly differ between the two groups (HR=1.389, 95% CI=0.926-2.085, p=0.079); how-ever, OS was significantly higher in the study group compared to the control group (HR=1.758, 95% CI=1.119-2.762, p=0.013).CONCLUSIONS: Fluorescein-guided micro-surgery can dramatically improve total resec- tion rate, postoperative neurological function-al status, and overall survival with higher ef-ficacy and safety in patients with high-grade gliomas.