TY - JOUR
T1 - The state of art of awake craniotomy in Latin American countries
T2 - a scoping review
AU - Figueredo, Luisa F.
AU - Shelton, William J.
AU - Tagle-Vega, Uriel
AU - Sanchez, Emiliano
AU - de Macedo Filho, Leonardo
AU - Salazar, Andres F.
AU - Murguiondo-Pérez, Renata
AU - Fuentes, Santiago
AU - Marenco-Hillembrand, Lina
AU - Suarez-Meade, Paola
AU - Ordoñez-Rubiano, Edgar
AU - Gomez Amarillo, Diego
AU - Albuquerque, Lucas Alverne F.
AU - de Amorim, Robson Luis Oliveira
AU - Vasquez, Carlos M.
AU - Baldoncini, Matias
AU - Mejia, Juan Armando
AU - Niño, Claudia
AU - Ramon, Juan Fernando
AU - Hakim, Fernando
AU - Mendez-Rosito, Diego
AU - Navarro-Bonnet, Jorge
AU - Quiñones-Hinojosa, Alfredo
AU - Almeida, Joao Paulo
N1 - Publisher Copyright:
© 2023, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2023/9
Y1 - 2023/9
N2 - Background and objective: Awake craniotomy (AC) is a valuable technique for surgical interventions in eloquent areas, but its adoption in low- and middle-income countries faces challenges like limited infrastructure, trained personnel shortage, and inadequate funding. This scoping review explores AC techniques in Latin American countries, focusing on patient characteristics, tumor location, symptomatology, and outcomes. Methods: A scoping review followed PRISMA guidelines, searching five databases in English, Spanish, and Portuguese. We included 28 studies with 258 patients (mean age: 43, range: 11–92). Patterns in AC use in Latin America were analyzed. Results: Most studies were from Brazil and Mexico (53.6%) and public institutions (70%). Low-grade gliomas were the most common lesions (55%), most of them located in the left hemisphere (52.3%) and frontal lobe (52.3%). Gross-total resection was achieved in 34.3% of cases. 62.9% used an Asleep-Awake-Asleep protocol, and 14.8% used Awake-Awake-Awake. The main complication was seizures (14.6%). Mean post-surgery discharge time was 68 h. Challenges included limited training, infrastructure, and instrumentation availability. Strategies discussed involve training in specialized centers, seeking sponsorships, applying for awards, and multidisciplinary collaborations with neuropsychology. Conclusion: Improved accessibility to resources, infrastructure, and adequate instrumentation is crucial for wider AC availability in Latin America. Despite disparities, AC implementation with proper training and teamwork yields favorable outcomes in resource-limited centers. Efforts should focus on addressing challenges and promoting equitable access to this valuable surgical technique in the region.
AB - Background and objective: Awake craniotomy (AC) is a valuable technique for surgical interventions in eloquent areas, but its adoption in low- and middle-income countries faces challenges like limited infrastructure, trained personnel shortage, and inadequate funding. This scoping review explores AC techniques in Latin American countries, focusing on patient characteristics, tumor location, symptomatology, and outcomes. Methods: A scoping review followed PRISMA guidelines, searching five databases in English, Spanish, and Portuguese. We included 28 studies with 258 patients (mean age: 43, range: 11–92). Patterns in AC use in Latin America were analyzed. Results: Most studies were from Brazil and Mexico (53.6%) and public institutions (70%). Low-grade gliomas were the most common lesions (55%), most of them located in the left hemisphere (52.3%) and frontal lobe (52.3%). Gross-total resection was achieved in 34.3% of cases. 62.9% used an Asleep-Awake-Asleep protocol, and 14.8% used Awake-Awake-Awake. The main complication was seizures (14.6%). Mean post-surgery discharge time was 68 h. Challenges included limited training, infrastructure, and instrumentation availability. Strategies discussed involve training in specialized centers, seeking sponsorships, applying for awards, and multidisciplinary collaborations with neuropsychology. Conclusion: Improved accessibility to resources, infrastructure, and adequate instrumentation is crucial for wider AC availability in Latin America. Despite disparities, AC implementation with proper training and teamwork yields favorable outcomes in resource-limited centers. Efforts should focus on addressing challenges and promoting equitable access to this valuable surgical technique in the region.
KW - Awake craniotomy
KW - Global neurosurgery
KW - Latino America
KW - Low and middle-income countries
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U2 - 10.1007/s11060-023-04433-0
DO - 10.1007/s11060-023-04433-0
M3 - Review article
C2 - 37698707
AN - SCOPUS:85171161940
SN - 0167-594X
VL - 164
SP - 287
EP - 298
JO - Journal of neuro-oncology
JF - Journal of neuro-oncology
IS - 2
ER -