Hypnosis-Aided Awake Surgery for the Management of Intrinsic Brain Tumors versus Standard Awake-Asleep-Awake Protocol: A Preliminary, Promising Experience.
Adult
Aged
Brain Neoplasms
/ psychology
Craniotomy
/ methods
Databases, Bibliographic
/ statistics & numerical data
Female
Humans
Hypnosis
/ methods
Karnofsky Performance Status
Magnetic Resonance Imaging
Male
Monitoring, Intraoperative
Retrospective Studies
Statistics, Nonparametric
Wakefulness
/ physiology
Young Adult
Awake surgery
Brain tumors
Glioma
Hypnosis
Intrinsic
Journal
World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275
Informations de publication
Date de publication:
Jan 2019
Jan 2019
Historique:
received:
20
07
2018
revised:
30
09
2018
accepted:
01
10
2018
pubmed:
14
10
2018
medline:
3
1
2019
entrez:
14
10
2018
Statut:
ppublish
Résumé
Hypnosis is a technique that could aid awake surgery protocols. The aim of the present study is to describe the results of a preliminary experience of a cohort of patients operated on with an original protocol of hypnosis-aided awake surgery (HAS). All patients were operated on with the aid of HAS and their data were retrospectively reviewed. A thorough literature review was conducted to compare the results of HAS with the standard awake surgery protocol regarding 1) the incidence of intraoperative pain; 2) the overall incidence of complications; 3) the length of time in which the patients were suitable for intraoperative neuropsychological testing; and 4) the incidence of gross total resection. The comparison presented a notably high statistical impact (1-β = 0.90-0.93 for α = 0.05; effect size, 0.5). The final cohort comprised 6 patients from our institution and 43 records retrieved in the relevant literature underwent HAS for intrinsic brain tumor treatment. This cohort was compared with cohorts of patients who were considered eligible through a literature review. HAS showed a statistically significant superiority in the first 3 outcome variables, whereas the incidence of gross total resection favored the standard awake approaches. According to the results, hypnosis-aided resection of intrinsic brain tumor located in eloquent areas is safe and effective, although dissociation phenomena deserve further investigation to be completely understood.
Sections du résumé
BACKGROUND
BACKGROUND
Hypnosis is a technique that could aid awake surgery protocols. The aim of the present study is to describe the results of a preliminary experience of a cohort of patients operated on with an original protocol of hypnosis-aided awake surgery (HAS).
METHODS
METHODS
All patients were operated on with the aid of HAS and their data were retrospectively reviewed. A thorough literature review was conducted to compare the results of HAS with the standard awake surgery protocol regarding 1) the incidence of intraoperative pain; 2) the overall incidence of complications; 3) the length of time in which the patients were suitable for intraoperative neuropsychological testing; and 4) the incidence of gross total resection. The comparison presented a notably high statistical impact (1-β = 0.90-0.93 for α = 0.05; effect size, 0.5).
RESULTS
RESULTS
The final cohort comprised 6 patients from our institution and 43 records retrieved in the relevant literature underwent HAS for intrinsic brain tumor treatment. This cohort was compared with cohorts of patients who were considered eligible through a literature review. HAS showed a statistically significant superiority in the first 3 outcome variables, whereas the incidence of gross total resection favored the standard awake approaches.
CONCLUSIONS
CONCLUSIONS
According to the results, hypnosis-aided resection of intrinsic brain tumor located in eloquent areas is safe and effective, although dissociation phenomena deserve further investigation to be completely understood.
Identifiants
pubmed: 30315969
pii: S1878-8750(18)32296-4
doi: 10.1016/j.wneu.2018.10.004
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e882-e891Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2018 Elsevier Inc. All rights reserved.