Abstract Details

Title Awake Craniotomy vs General Anesthesia for Excision of Brain Tumors: First Case-control Study from a Low-and-middle-income Country

Topic Neuro-oncology

Presentation(s) P1 - Poster Session 1 (9:00 AM-5:00 PM)

Poster/Presentation
Number 424

Objective To compare the clinical outcomes of Awake Craniotomy to Craniotomy under general anesthesia.

Background Data from developed countries has shown that awake craniotomy (AC) improves outcomes of brain tumor resection. However, no such data is available from low-and-middle-income countries.

Design/Methods This was a retrospective case-control study. Cases included all AC performed at our hospital for brain tumor excision in last 5 years, and controls included first 100 tumors resected under general anesthesia (GA) during the same time period. Data collected included demographics, tumor location/histology, clinical complains and functional status. We used Karnofsky performance scale (KPS) to assess function. Extent of resection was determined on post-operative MRI.

Results Two hundred AC cases were compared with 100 cases performed under GA. Mean age was 39.3 ± 11.9 years in the AC group and 45.9 ±13.1 years in the GA group. Patients in the AC arm had a significantly less hospital stay than the GA arm (3.15 ± 1.7 days vs 5.26 ± 1.7 days; p <0.001). Extent of resection was better in the AC group than the GA group (p = 0.001); gross total resection was achieved in 82 (41%) AC patients and in 32 (32%) GA patients. New post-operative neurological complains were seen in 19 (19%) GA patients, as compared to only 14 (7%) patients who developed intra-operative deficits during AC (p = 0.015). Only 2 (1%) of AC patients had persistent deficits at last follow-up, as compared to 7 (7%) patients under GA. Comparison of mean pre-operative KPS of the two groups was not statistically different (p = 0.071), but there was significantly better KPS at last follow-up in the AC cases than in the control group (p = 0.009).

Conclusions AC offers a good chance of preserving patients’ functional status with better resection and less hospital stay than tumor resection under GA.

Authors/Disclosures
Jaleed A. Gilani, MBBS (Aga Khan University) PRESENTER	Dr. Gilani has nothing to disclose.
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