Principles and strategies of surgical treatment of plexiform neurofibromas
10.3760/cma.j.cn114453-20220911-00282
- VernacularTitle:丛状神经纤维瘤的手术原则及策略
- Author:
Beiyao ZHU
1
;
Yihui GU
;
Wei WANG
;
Chengjiang WEI
;
Bin GU
;
Qingfeng LI
;
Zhichao WANG
Author Information
1. 上海交通大学医学院附属第九人民医院整复外科，上海 200011
- Keywords:
Neurofibromatosis 1;
Surgical procedures;
Magnetic resonance imaging;
Angiography;
Embolism;
Intraoperative neurophysiological monitoring;
Recurrence
- From:
Chinese Journal of Plastic Surgery
2023;39(11):1244-1250
- CountryChina
- Language:Chinese
-
Abstract:
Plexiform neurofibromas (pNF) is significant hallmark of type Ⅰ neurofibromatosis, posing substantial negative impacts on patients’ quality of life and daily functionality. Surgical intervention remains the primary modality of treatment. However, the surgery is fraught with challenges due to the rich vascularization, intricate neural involvement, and ill-defined borders of the tumors. The risk of recurrence and complications further complicates the surgical approach. Through extensive literature review and integrative analysis, this article summarizes the current surgical treatment options and adjunctive techniques available for pNF management. Preoperative radiological assessments, vascular embolization, intraoperative neural monitoring, and fluorescence navigation are among the ancillary techniques that can effectively mitigate surgical risks. The timing of surgery should be guided by specific indications and contraindications, while the surgical plan must be individualized based on the patient’s unique presentation, sometimes necessitating a multidisciplinary approach. Overall, a comprehensive assessment of the patient’s condition and the implementation of multifaceted adjunctive measures are imperative for maximizing tumor resection while minimizing the risks of recurrence and complications.
