Pinhole surgery has less side effects: Doc

CHANDIGARH: Though there has not been anything new in the field of treatment for brain tumors, but there has been improvisation of surgical techniques where there has been less exposure of the surrounding brain structures, and side effects have been reduced significantly.

As Prof SS Dhandapani, department of neurosurgery in PGI, said, "We have been doing keyhole and minimally invasive surgeries for brain tumors since a while. I have stopped giving anti epileptic/seizures drugs after a week to my patients as there is no brain handling with this surgery."

Conventionally, the skull has to be opened, but in this minimally invasive operation, the surgeons approach the base of the skull using an endoscope. "The outcome of the surgery depends on the grade of the tumor and not the size. If the tumor is high grade, there is low life expectancy and this has not improved over the last decades," said the neurosurgeon. Also, there is no database or brain tumor registry nationally. "To understand the burden and the life expectancy of a disease, such a database is crucial," said a surgeon.

In PGI, the largest brain tumor operated using keyhole technique has been 6.5-7cm where the tumor was bigger than the bony opening of the skull. In such cases, the tumor is cut into pieces for removal. "For benign or low grade tumors, the surgical tumor is a cure. But for intermediate and high grade tumors, the life expectancy is low. For instance, in Glioblastoma (GBM) , a fast-growing and aggressive brain tumor, the -median expectancy is 1 -2 years, implying that some may survive for 3 months to 10 years with chemotherapy and radiotherapy after surgery. There has been no paradigm shift in tumor treatment," said Dhandapani. The advantages of the skilled technique is that the seizures have become almost nil, and behavioural alteration and mental impairments have reduced due to less exposure to the surrounding brain parts.