Functional Outcomes in Patients with Low Grade Gliomas; The Effect of the Extent of Resection

Objectives: The resection of low grade gliomas is still a matter of controversy, despite the fact that total resection is the ultimate goal of surgery, the safety of resection regarding the quality of life is more important, this study compares the outcome of surgical resection of low grade gliomas in different settings of radicality, and describe the factors affecting surgical decision making. Methods: A retrospective study was conducted including 30 patients with radiological diagnosis of LGG, analysis of data was done, preoperative functional MRI was done todetermine the eloquency of affected areas of the brain. Intraoperative trans sulcal gross excision was performed and patients were thoroughly examind for neurological deficits. Results: Total excision was performed in 26.7% of cases, near total in 40% subtotal in 30% and 3% had only biopsy of the lesion, 23% showed post operative deficit which reduced to less than 10% at the end of the follow-up period. Conclusion: This study highlights the importance of the extent of resection, the preoperative neurological status, the eloquence of the affected cortical area, and the preoperative determination of the resectable area by the use of preoperative functional MRI, and tractography, with integration of intraoperative navigation techniques for proper excision and preservation of high postoperative quality of life.