Gökhan KURT, Ömer Hakan EMMEZ, Şükrü AYKOL, Özgür ÖCAL, Erkut Baha BULDUK, Ayfer ASLAN

Beyin kitle lezyonlarının stereotaktik biyopsisi: Üçüncü basamak hastane deneyimi

Giriş: Stereotaktik biyopsi , hassas beyin bölgelerindeki lezyonlar için uygulanan bir tekniktir. Amaç: Bu çalışmanın amacı stereotaktik biyopsinin tanısal güvenilirliğini ve risk oranını ortaya koymaktır. Yöntemler: Çeşitli intrakranyal lezyonlar nedeniyle stereotaktik biyopsi uygulanan hastaların verileri geriye dönük olarak toplanmıştır. Çalışma, Şubat 2004 ile Nisan 2014 tarihleri arasında Gazi Üniversitesi Tıp Fakültesi Nöroşirürji Anabilim Dalı'nda gerçekleştirilmiştir. Veri analizi; yaş, cinsiyet, lezyon yeri, histopatoloji ve cerrahi operasyon sonuçlarına göre yapılmıştır. Bulgular: Hasta sayısı; yaşları 11 ile 84 arasında (ortalama yaş 49), yüzde altmışı erkek (146 hasta) ve yüzde kırkı kadın (96 hasta) olmak üzere toplam 242 idi. Mortalite ve morbidite oranları sırasıyla %0,4 ve %3,3'tür. Tanı koyma oranı %81 (196 hasta) iken, %19'unda (46 hasta) tedavi modalitesini ilerletemeyeceğimiz nonspesifik sonuçlar vardı. Patolojileri eksizyonel biyopsi ile onaylanan 36 hasta arasında tanısal doğruluk 24 hastada görüldü (%67). Sonuç: Düşük mortalite ve morbidite riski yanında, tanısal olmayan sonuçların yüksek ve tanısal doğruluğun düşük oranı stereotaktik biyopsinin sınırlamalarıdır. Daha fazla numune almak için dikkatli beceri, planlama için gelişmiş yazılım kullanımı ve intraoperatif patolojik inceleme ile tanısal doğruluk oranı arttırılabilinir.

Stereotactic biopsy of the brain mass lesions: a tertiary hospital experience

Objectives: Stereotactic biopsy (SB) is a guided technic performed for the lesions on eloquent brain areas. The aim of this study is revealing the diagnostic reliability and the risk ratio of SB. Methods: Data of patients performed SB due to various intracranial lesions was collected retrospectively. The study took place in Department of Neurosurgery, Gazi University Faculty of Medicine between February 2004 and April 2014. Data analysis performed in terms of age, gender, lesion location, histopathology, and outcomes of surgery. Results: Sixty percent of patients were male (146 patients) and forty percent of them was female (96 patients), between the ages of 11 and 84 years (mean age of 49 years) with a total number of 242. Mortality and morbidity rates were respectively 0.4% and 3.3%. The overall diagnostic yield was 81% (196 patients), while 19% (46 patients) had nonspecific results, which did cannot lead any further therapy. Among 36 patients of whom pathologies were confirmed with an excisional biopsy, the diagnostic accuracy was shown in 24 patients (67%). Conclusions: Beside low risk of mortality and morbidity, the high rate of non-diagnostic results and low rate of diagnostic accuracy are the limitations of SB, which should be improved by careful skills to obtain more specimen, sophisticated software for planning, and intraoperative pathological examination for guaranteeing.

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