Principal Director & HOD, Neuro and Spine Surgery, Fortis Hospital, Shalimar Bagh, New Delhi
Part 6 of 9 in Diagnosis and Management of Brain Tumour
Brain Tumour Surgery: Realistic Complication Rates and Recovery
June 9, 2024
Modern brain tumour surgery carries a lower complication rate than many patients expect, and understanding the realistic risk profile helps set expectations before surgery.
Complication rate and what can occur
Post-operative complications have come down to under 5% of cases. When they occur, they include epilepsy, a haematoma (blood clot) at the surgical site, infection related to open surgery, and, if a tumour is very large, the possibility that a portion has to be left behind rather than removed in a single operation.
What happens to the surgical cavity
After a cancerous mass is removed, some microscopic tumour cells are always left behind since complete removal of a malignant tumour is not possible. The cavity created by the resection is not itself a lasting concern: because these tumours are associated with significant surrounding brain swelling, the cavity fills in on its own fairly quickly during healing.
This article is based on a Jivo Masterclass session conducted by Dr. Sonal Gupta, Principal Director & HOD, Neuro and Spine Surgery, Fortis Hospital, Shalimar Bagh, New Delhi. The article has been summarised with the assistance of an AI tool from the original masterclass recording. Watch the full Masterclass recording
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This guide is based on a live Jivo Masterclass: Dr. Sonal Gupta taught doctors across Africa on June 9, 2024.
FROM THE LIVE Q&A
Moderator
What are the post-operative complications of brain tumour surgery?
Dr. Sonal Gupta
Complications have come down to under 5% of cases. They include epilepsy, a haematoma (clot) at the surgical site, infection from open surgery, and, if the tumour is very large, the possibility that a portion has to be left behind.
Frequently Asked Questions
Will children benefit from epilepsy surgery at an early age?▼
Yes. If a child is dependent on multiple anti-epileptic medications, surgery helps by reducing both the number of medications needed and their side effects.
A 19-year-old has been on epilepsy follow-up and medication for 10 years. The MRI is negative, but the EEG shows a slow-wave background. What is the next step?▼
This patient should be referred for a dedicated epilepsy workup.
After a complete resection of a cancerous mass, there is a void left in the brain. How does this void evolve during healing, and are there always neurological sequelae?▼
A cancer tumour can never be removed completely; microscopic cells are always left behind. Because these tumours cause significant surrounding brain swelling, the surgical cavity fills in quickly on its own, so the void itself is not a concern.
A 7-year-old girl presented with a two-week history of headache and vomiting that progressed over the last three days. MRI showed a well-defined left frontal lobe mass with a differential of metastasis versus high-grade glioma, and local doctors are recommending a frontal lobectomy. What would you recommend, and what are the likely outcomes?▼
Rather than an open frontal lobectomy, neuronavigation-guided keyhole tumour surgery using a surgical robotic system allows near-complete removal of high-grade tumours, improving survival, though high-grade tumours cannot be described as fully curable. This is typically followed by stereotactic radiosurgery and chemotherapy or immunotherapy depending on the biopsy, guided by genetic study of the tumour, which few centres worldwide perform routinely.
Is immunotherapy actually used in the treatment of brain tumours?▼
Yes. Genetic-based targeted immunotherapy is the latest advancement in brain tumour treatment.
What is the complication rate of brain tumour surgery today?▼
Under 5% of cases, with the main risks being epilepsy, a haematoma at the surgical site, infection, or, for very large tumours, a portion left unremoved.
Does the cavity left after tumour removal cause lasting problems?▼
No - it fills in fairly quickly during healing due to the brain swelling associated with these tumours, and is not itself a lasting concern.
In This Series: Diagnosis and Management of Brain Tumour
- 1.Brain Tumour
- 2.How Brain Tumours Are Classified: Benign, Malignant, Primary and Secondary
- 3.Brain Tumour Symptoms and Which Headaches Are Red Flags
- 4.Diagnosing Brain Tumours: CT, MRI and Beyond
- 5.Brain Tumour Surgery and Radiosurgery: Treatment Options Explained
- 6.Brain Tumour Surgery: Realistic Complication Rates and Recovery
- 7.Epilepsy Surgery: Who Needs It and How It Helps
- 8.Brain Tumours in Children and Newborns: Diagnosis and Management
- 9.Real Brain Tumour Cases: Weighing Surgery Against Radiosurgery