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(Adnkronos Salute) - "Innovativi interventi di asportazione di tumore cerebrale con pazienti svegli e collaboranti" sono stati eseguiti dalla Neurochirurgia dell'Azienda ospedaliero-universitaria Senese (Aous), che descrive "2 casi molto particolari. Entrambi i pazienti non erano di madre lingua italiana ed è stata proprio la valutazione dell'area del linguaggio il leitmotiv degli interventi". Il primo caso riguarda una giovane donna con una neoplasia nell'area frontale sinistra, in prossimità dell'area espressiva del linguaggio e motoria, riporta l'Aous; il secondo un uomo giovane con una neoplasia nel lobo temporale sinistro, in prossimità dell'area della comprensione del linguaggio. "Per rimuovere le lesioni nelle aree del movimento e della parola e preservare le loro funzioni cognitive superiori, è stato necessario parlare con i pazienti nel corso di tutto l'intervento sul cervello - spiega Francesca Tarantino, direttrice dell'Anestesia e Rianimazione neurochirurgica e ad interim della Neurochirurgia, che ha coordinato l'équipe operatoria multidisciplinare - A tal fine è stato fondamentale modulare il piano di anestesia in modo da garantire, dopo una prima fase di sedazione più profonda, una successiva di blanda analgesia ed infine nuovamente una fase di approfondimento della sedazione: il tutto per salvaguardare la capacità di collaborazione e di risposta agli stimoli da parte del paziente sveglio, privo di dolore e in respiro spontaneo per tutta la durata dell'intervento. Entrambi i pazienti si esprimevano in un buon italiano come seconda lingua e sono stati aiutati dalle mediatrici linguistiche che sono state presenti in sala operatoria, in entrambi i casi, per interloquire nelle due diverse lingue con i pazienti. Le mediatrici, Noemi Muho e Jemmali Ghada, hanno dato un contributo importate perché durante l'intervento era fondamentale valutare e proteggere tutte le competenze linguistiche dei pazienti, sempre sotto monitoraggio continuo dei parametri vitali da parte del team anestesiologico"."Durante la procedura chirurgica - aggiunge Salvatore Chibbaro, esperto di questo tipo di neurochirurgia, primo operatore degli interventi - per monitorare l'integrità funzionale delle aree cerebrali sottoposte ad intervento è stato chiesto ai pazienti sia di descrivere delle immagini che vedevano, che di leggere dei testi nella loro lingua madre, sempre con il contributo delle mediatrici linguistiche. Per proteggere anche le aree motorie più profonde sono stati usati stimoli elettrici cranici con registrazione diretta e continua (real time) delle risposte dagli arti, usando un metodo innovativo messo a punto dal neurochirurgo e neurofisiologo dello staff, Alessandro Zalaffi. Grazie a queste tecniche evolute, che comprendono anche l'utilizzo del modernissimo esoscopio con filtri per sostanze fluorescenti, è stato possibile asportare più del 90% di entrambi i tumori. La rimozione ampia, senza generare danni cerebrali permanenti, preservando tutte le funzioni superiori, è lo scopo finale da raggiungere in questi pazienti. A tal fine è indispensabile un lavoro di squadra e un team multidisciplinare preparato, motivato e coeso. Vista la particolarità dei casi, nei giorni successivi agli interventi si è svolto un incontro di approfondimento a Siena con i colleghi dell'Azienda ospedaliero universitaria Careggi, esperti di questo tipo di interventi e anche per possibili future collaborazioni, con apprezzamenti per la tecnica senese che consiste nell'operare i pazienti da svegli fin dall'inizio e per tutta la durata della procedura che rappresenta un'innovazione e avanzamento notevole in questo tipo di chirurgia". di Adnkronos   25-07-2024 - 16:39 Link copiato Commenti Leggi la Netiquette

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