SynthesisNeurosurgical review2020
Post-operative morbidity ensuing surgery for insular gliomas: a systematic review and meta-analysis.
Synthesis in Neurosurgical review, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Awake surgery versus general anesthesia in the treatment of Diffuse Low-Grade Gliomas - and the role of supplementary intraoperative techniques: a systematic review and meta-analysis.Journal of neuro-oncology · 2026Pooled it
- Seizure outcome after resection of insular glioma: a systematic review, meta-analysis, and institutional experience.Journal of neurosurgery · 2023Pooled it
- Laser Interstitial Thermal Therapy for Brain Tumors: A Prospective Multicenter Analysis of Patients From the LAANTERN Study.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2026Article
- Impact of postoperative blood pressure management on postoperative hemorrhage after resection of intraparenchymal brain tumors.Acta neurochirurgica · 2026Article
- Intraoperative Hemodynamic Management and Cerebral Protection During Awake Craniotomy: Evidence-Based Approaches.Anesthesiology research and practice · 2026Review
- Surgical timing guided by progressive cognitive decline in a left insular tumor without neurological deficits: A case report.Surgical neurology international · 2026Article
- Safety and Efficacy of Intraoperative Neuromonitoring: An Umbrella Review.Health science reports · 2025Review
- Potential predictors of awake surgery failure for insular glioma.Scientific reports · 2025Article
- Safety and Efficacy in the Transcortical and Transsylvian Approach in Insular High-Grade Gliomas: A Comparative Series of 58 Patients.Current oncology (Toronto, Ont.) · 2025Article
- Sudden Loss of Motor-Evoked Potentials (MEPs) During the Resection of A Nondominant Insular Glioma: Case Report and Management Review.Acta neurochirurgica. Supplement · 2025Article
- Mini-strokes within Broca-caudate connections during left insular glioma awake surgery cause transient severe naming deficits.Acta neurochirurgica · 2024Article
- The role of postoperative blood pressure management in early postoperative hemorrhage in awake craniotomy glioma patients.Neurosurgical review · 2024Article
- Factors affecting the extent of resection and neurological outcomes following transopercular resection of insular gliomas.Acta neurochirurgica · 2024Article
- Surgical treatment for insular gliomas. A systematic review and meta-analysis on behalf of the EANS neuro-oncology section.Brain & spine · 2024Review
- Review
- Anatomical aspects of the insula, opercula and peri-insular white matter for a transcortical approach to insular glioma resection.Neurosurgical review · 2022Article
- Laser interstitial thermal therapy for the treatment of insular lesions: A systematic review.Frontiers in neurology · 2022Article
- Pediatric and Adult Low-Grade Gliomas: Where Do the Differences Lie?Children (Basel, Switzerland) · 2021Review
- Surgical strategy for insular glioma.Journal of neuro-oncology · 2021Review
- Awake Surgery for Left Posterior Insular Low-Grade Glioma Through the Parietorolandic Operculum: The Need to Preserve the Functional Connectivity. A Case Series.Frontiers in surgery · 2021Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The surgical resection of insular gliomas remains a challenge. Middle cerebral artery perforating arteries and deep functional pathways affect the extent of resection and the rate of post-operative morbidity. The authors performed a systematic review and meta-analysis of the literature examining early and permanent post-operative deficits in patients who underwent resection of insular gliomas using awake craniotomy with direct electrical stimulation (DES) versus surgery under general anesthesia. A systematic search of three databases was performed for studies published between 1990 and 2018. Random-effect meta-analysis was used to pool the rate of early and permanent post-operative deficits. Random-effect meta-regression was used to examine the association between the rate of post-operative deficit and the anesthesia protocol. We included eight studies evaluating 227 patients with insular glioma. The rate of permanent sequelae was lower after awake craniotomy with DES (3.5% vs 15.7%; P = .001), and early deficits were lower after surgery under general anesthesia (27.3% vs 47.7%; P = .04). Awake surgery was significantly more common among patients with tumor located within the dominant hemisphere (P < .001). No significant association arose between the rates of post-operative deficits and the use of intraoperative neuronavigation and the neurophysiological monitoring. Furthermore, neither extent of resection nor tumor histology influenced the onset of permanent sequelae. Awake craniotomy with DES is associated with a significantly lower rate of permanent neurological morbidity after an early increase of transient post-operative deficits. These data support the use of awake mapping in insular glioma resection.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.