Novel neurosurgery performed in Holguín hospital
- Written by Lourdes Pichs Rodríguez
- Published in Health
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Neurosurgery in Holguín is back in the news with the first resection of a glioma in the left temporal lobe with intraoperative neurophysiological monitoring (MIO) performed in eastern Cuba on a 48-year-old patient suffering from a lesion to the system central nervous, who was operated on Friday 17 by a multidisciplinary team at the Lucía Íñiguez Landín hospital.
The new surgical procedure, based on the use of various techniques to remove the malignant tumor, was performed on Erides Almarales, resident in the municipality of Báguanos, by young neurosurgeons, who had the assistance of the specialist in Clinical Neurophysiology and DrC Arquímedes Montoya and his work team, from the Dr. Juan Bruno Zayas General Hospital, in Santiago de Cuba.
The chief neurosurgeon Dr. Freddy Varona explained that after analyzing the particularities of the glioma they decided to “jointly use the fluorescein protocol - a drug that pigments the most vascularized and damaged areas - with microscopic surgery and neurophysiological monitoring that makes possible to differentiate, through the electrical pattern of the brain, the healthy tissue of the patient”.
Varona added that in all the process they count on the help of Professor Montoya, who used the neuromonitoring technique to locate the motor and sensitive areas to avoid damaging them during the resection of the lesion.
For his part, nuerosurgeon José Miguel Pastor Rojas explained that "this elective major surgery was very well planned jointly between the Holguin and Santiago de Cuba medical team to introduce a novel treatment here, which was only performed in the International Center for Neurological Restoration (Ciren) in Havana.”
Both agreed that in this type of surgery the coordinated and professional participation of all participants is decisive, while the role of anesthesiologists is essential. "We were suggested to use a total intravenous anesthesia (TIVA), to use multiple drugs with low doses and prevent the patient from having an anesthetic block in the cerebral cortex that did not allow its registration, therefore we all had to work in unison , using very low doses of medication, so as not to block the cerebral cortex and in this way allow the neurophysiologist to do the examination and this, in turn, would guide us as to what areas of surgery we could be working on. "
The head of the team acknowledged that “this coordinated action made it easier for the patient's electrical pattern to remain stable, which when compared to that performed in the postoperative period showed the same behavior, that is, the invasive action did not cause any new injury to that already established by the tumor. "
The patient evolves well one week after his operation, he only maintains motor aphasia (difficulty in emitting the words), which can improve in the coming days; he understands everything said to him and follows the orders of the specialists while recovering in the Neurosurgery Room, after his stay in the Intensive Care Unit.
Performing this risky surgical procedure constitutes a high satisfaction, achieved in times of great pressure due to the effects of the economic, commercial and financial blockade of the United States against the country and a great tension in post-COVID-19 times.
Dr. Varona pointed out that tumor surgeries in the central nervous system exceed 100 thousand or 120 thousand dollars, but in Cuba for all nationals surgical treatment, such as medication and hospitalization are free, without distinction.