Surgical Considerations of Maximal Safe Resection of Adult Diffuse Low-Grade Glioma

Background: Most adults with Diffuse Low-Grade Gli-omas (DLGGs) are identified around the age of 39, and they are usually completely normal when they are diagnosed. Most people know that the extent of resection (EOR) affects overall mortality (OS). In the past 20 years, surgery for Diffuse Low-Grade Gliomas (DLGGs) has changed a lot. Implementing mul-tiple surgical tools into the process of tumor excision has a great impact on both the EOR and the safety of the patients. Aim of Study: To evaluate the impact of the technological advancements and integration of multidisciplinary techniques on Extent of maximal safe resection of DLGGs. Patients and Methods: This is an Observational retro-spective study performed in period of almost 6 months, from May/2022 till November /2022 operated in Kasr Al-Ainy Hos-pitals to evaluate the impact of the technological advancements and the integration of multidisciplinary techniques on EOR and its clinical post-operative outcomes. 20 patients affected by DLGGs were enrolled in this study. Multiple intraoperative techniques have been utilized to offer safer surgery with max-imum extent of resection; awake surgery, IV fluorosceine dye injection, localizing the tumor by utilizing craniometric points, Cortical and subcortical mapping and direct Electrical stimula-tion (DES). Results: Our study showed that patients who underwent AC (awake craniotomy) had better impact on the EOR in com-parison to those operated under GA (p=0.006) supporting the importance of AC for DLGGs in eloquent areas.