ArticleFrontiers in surgery2026
Safety and surgical outcomes of sodium fluorescein-guided pediatric brain tumor surgery: a retrospective before-and-after single-center cohort study.
Article in Frontiers in surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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8 authors.
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Abstract
Purpose: Sodium fluorescein (SF) used with a YELLOW 560-nm filter may improve intraoperative visualization of contrast-enhancing brain tumors, but pediatric evidence remains limited. We assessed the feasibility, safety, and surgical outcomes of SF-guided resection in a single-center pediatric cohort. Methods: We retrospectively analyzed pediatric brain tumor resections performed between 2015 and 2023 using a before-and-after design based on the institutional introduction of SF. SF-guided procedures were compared with historical white-light controls. Inclusion required a contrast-enhancing intracranial tumor considered amenable to gross total resection (GTR). SF was administered intravenously at 2 mg/kg. The primary endpoint was radiographically confirmed GTR within 72 h; operative duration, postoperative course, complications, and follow-up outcomes were secondary exploratory endpoints. Exploratory multivariable logistic regression for GTR included SF use, age, sex, and supra- vs. infratentorial location. Operative duration was compared using a two-sided Mann-Whitney Results: Among 60 procedures in 50 patients, 32 were performed with SF and 28 without SF. GTR was achieved in 93.8% of SF-guided and 71.4% of non-SF procedures (absolute difference, 22.4 percentage points; Fisher's exact Conclusion: Low-dose SF was safe and feasible and was associated with higher GTR rates and lower operative duration. However, the historical-control design, limited number of non-GTR outcomes, heterogeneous tumors, baseline differences, unequal follow-up, and residual confounding preclude causal or long-term oncological conclusions. Prospective validation is required.
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