Surgical treatment of Brain Astrocytoma in Germany
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Department of Adult and Pediatric Neurosurgery
The Department of Adult and Pediatric Neurosurgery offers the full range of accurate diagnostics and surgical treatment of diseases of the central and peripheral nervous system. The department's surgeons annually perform over 5,000 surgical interventions, which indicates their high professionalism and tremendous experience. The key attention is paid to the treatment of cerebrovascular diseases, diseases of the spine and spinal cord, brain and skull base tumors, peripheral nerve lesions, cerebrospinal fluid circulation disorders, as well as pain therapy (functional neurosurgery). The treatment of neurosurgical diseases in children and adolescents is carried out by a specially trained team of experts.
Department of Adult and Pediatric Neurosurgery
The Department of Adult and Pediatric Neurosurgery offers the full range of surgical treatment of diseases of the brain, spine, spinal cord and nerves in adults and children. The department keeps pace with new trends in medicine, as well as contributes significantly to their development. Therefore, the most modern diagnostic and therapeutic methods are available here. An individual approach to each clinical case is crucial to ensure optimal treatment results with the preservation of all neurological functions.
Department of Adult and Pediatric Neurosurgery
According to the Focus magazine, the Department of Adult and Pediatric Neurosurgery ranks among the top German medical facilities specializing in the surgical treatment of brain tumors! The department offers the full range of diagnostics and surgical treatment of diseases of the central and peripheral nervous system. A specially trained team of pediatric neurosurgeons provides treatment for various neurosurgical pathologies in children. During the treatment, the doctors use state-of-the-art equipment, in particular, imaging-guided neuronavigation, functional imaging (fMRI), intraoperative mapping, intraoperative videoangiography, etc.
Department of Adult and Pediatric Neurosurgery
The Department of Adult and Pediatric Neurosurgery offers the diagnostics and treatment of the entire spectrum of neurosurgical diseases. The department specializes in the treatment of brain tumors, vascular diseases and intracerebral hemorrhages, spinal diseases, deep brain stimulation, etc. Special competence lies in the field of pediatric neurosurgery. The department offers the very latest highly accurate and minimally invasive treatment methods.
Department of Neurosurgery
The Department of Neurosurgery offers the full range of surgical treatment of diseases of the nervous system and belongs to the largest medical facilities of this kind at the national level. The department has 4 state-of-art operating rooms where more than 2,700 interventions are performed annually. It has the progressive surgical equipment, for example, intraoperative monitoring, neuronavigation, tools for performing minimally invasive operations, which provide the most effective and reliable therapy. The department has earned the reputation of the Center of Competence in the field of tumor surgery of the nervous system and spine.
Department of Adult and Pediatric Neurosurgery, Epilepsy Surgery, Spinal Surgery
The Department of Adult and Pediatric Neurosurgery, Epilepsy Surgery, Spinal Surgery offers the full range of diagnostics and surgical treatment of diseases of the brain, spinal cord and peripheral nerves at the highest international level of modern medicine. The department has four high-tech operating rooms, in which more than 2,400 surgical interventions are performed annually. Surgery to treat tumors of the nervous system in childhood and adulthood is of particular interest to the department's specialists. In addition, the department's medical team has unique clinical experience in the surgical treatment of epilepsy, spinal pathologies and deformities, as well as neurovascular pathologies. The department's doctors have a perfect command of advanced surgical techniques, for example, navigational surgery, intraoperative neuromonitoring, hybrid surgical techniques, which are the basis of successful clinical practice. State-of-the-art computer-assisted systems allow neurosurgeons to plan each stage of surgical intervention as accurately as possible, thereby guaranteeing its high efficiency and safety.
Department of Adult and Pediatric Neurosurgery, Spinal Surgery
The Department of Adult and Pediatric Neurosurgery, Spinal Surgery offers modern diagnostics and effective treatment of the full range of diseases, injuries, inflammatory processes, tumors and malformations of the brain, spinal cord and their meninges, as well as spinal diseases. Spinal surgery is performed in collaboration with doctors from the Department of Adult and Pediatric Traumatology, Orthopedic Surgery. The department admits adults and children with malformations of the nervous system, brain and spinal cord tumors, drug-resistant epilepsy and other diseases. As one of the largest medical facilities of this kind in Germany, the department's doctors annually perform more than 2,500 surgical interventions on the brain and spinal cord, peripheral nerve endings. The department's specialists also perform over 400 spinal surgical procedures annually. To achieve high success rates of the surgical treatment, doctors use the very latest equipment, including neuronavigation systems. Thanks to this, surgeons not only successfully eliminate the pathology, but also guarantee the patient maximum safety. The department has 78 beds, including 14 beds in the Intensive Care Unit. The priority goal of the department's medical team is to provide high-quality treatment focused on the patient's needs.
Department of Adult and Pediatric Neurosurgery
The Department of Adult and Pediatric Neurosurgery offers the diagnostics and comprehensive treatment of neurosurgical pathologies, including tumors of the central and peripheral nervous system. The department is the leading Center of Neurosurgery in Northern Germany and is responsible for the implementation of new algorithms for the treatment of patients with brain tumors. To this end, there is an active participation in the international researches and the development of new surgical methods, for example, operations in the waking state. Close interdisciplinary cooperation also contributes to the achievement of optimal treatment results.
Department of Neurosurgery and Spinal Surgery
The Department of Neurosurgery and Spinal Surgery provides top-class medical care for patients with diseases of the central and peripheral nervous systems. The medical facility performs surgery of any complexity on the brain, spinal cord, spine, and peripheral nerves. The department is the largest healthcare facility of this kind in Germany and has a team of highly professional neurosurgeons with long clinical experience. The department's specialists focus on patients with brain tumors (gliomas, meningiomas, and brain metastases), neurovascular diseases (aneurysms, arteriovenous malformations, and dural arteriovenous fistulas), and traumatic brain injuries. Spinal surgeons operate on patients with herniated discs, spinal canal stenosis, spondylolisthesis, spondylodiscitis, spinal fractures, and spinal tumors. The department extensively uses minimally invasive surgical techniques that allow for good therapeutic results with high safety in surgical manipulations. The medical facility has two hybrid operating rooms with state-of-the-art equipment, including the Zeego® intraoperative robotic angiography system and the intraoperative Brainsuite® MRI.
Department of Adult and Pediatric Neurosurgery
The Department of Adult and Pediatric Neurosurgery offers the full range of diagnostics and treatment of diseases of the central and peripheral nervous system. The medical institution occupies a leading position in this sector in Europe. The neurosurgeons of the department have at their disposal four high-tech operating rooms, in which more than 3,500 interventions are performed annually. Active clinical and experimental research activities, as well as close cooperation with national and international reputable research centers, promote the introduction of innovative treatment techniques that are available only in a few clinics in the world.
Department of Adult and Pediatric Neurosurgery
The Department of Adult and Pediatric Neurosurgery offers the widest range of surgical interventions for the treatment of diseases of the central and peripheral nervous system, including stereotactic surgery and endoscopy. With more than 2,400 operations every year, the department has a unique experience, which allows it to provide the high-quality medical care even in extremely complex clinical cases. The key focus of the department is pediatric neurosurgery. In addition to the high professionalism of doctors, the treatment success is facilitated by exclusively advanced medical equipment, for example, neuronavigation systems and intraoperative fluorescence navigation.
Department of Adult and Pediatric Neurosurgery
The Department of Adult and Pediatric Neurosurgery offers the full range of modern services in this medical field. The high level of technical equipment in the department allows for the performance of all highly specialized surgical interventions to treat pathologies of the central and peripheral nervous system. The clinical practice mainly focuses on the diagnostics and surgical treatment of diseases, injuries of the brain, spine, spinal cord, intervertebral discs, nerve plexuses, functional neurosurgery and the treatment of neurosurgical pathologies in children.
Department of Adult and Pediatric Neurosurgery
The Department of Adult and Pediatric Neurosurgery offers all modern surgical interventions for the treatment of pathologies of the nervous system. The clinical focuses include the treatment of oncological diseases of the nervous system (neuro-oncology), skull base surgery, vascular neurosurgery, spinal surgery and functional neurosurgery, including the surgical treatment of epilepsy. As a state-of-the-art medical facility, the department has the advanced systems for deep brain stimulation, multimodal neuronavigation devices, intraoperative neuronavigation using CT, ultrasound systems, fluorescence imaging devices and endoscopy equipment. Thus, the department has all the possibilities to ensure effective treatment according to the international standards.
Department of Adult and Pediatric Neurosurgery, Spinal Surgery
The Department of Adult and Pediatric Neurosurgery, Spinal Surgery specializes in performing surgical procedures of any complexity on the brain, spinal cord, spine, and peripheral nervous system in patients of all ages. The department's operating rooms are equipped with the latest technology to ensure the most effective and safe treatment of neurosurgical pathologies. During surgery, the department's specialists use innovative intraoperative neuromonitoring systems, neuronavigation devices, and continuous electrophysiologic monitoring systems. The department employs skilled neurosurgeons with extensive clinical experience and in-depth expertise, who prioritize effective treatment according to each patient's individual needs. The physicians strictly follow current clinical protocols and recommendations of the German Society of Neurosurgery (DGNC). It should be noted that the department is part of the Center for Neuro-Oncology certified by the German Cancer Society (DKG), has the status of a Center for Spine Surgery certified by the German Spine Society (DWG), and a Center for Skull Base Surgery certified by the German Society for Skull Base Surgery (GSB).
Department of Adult and Pediatric Neurosurgery, Spinal Surgery
The Department of Adult and Pediatric Neurosurgery, Spinal Surgery offers the full range of diagnostic examinations and surgical treatment of diseases of the central and peripheral nervous systems. The team of the department's neurosurgeons successfully performs operations for pathologies of the brain and spinal cord, spine, neurovascular pathologies, pituitary diseases, and epilepsy. The doctors specialize in surgery for malignant brain tumors. The department is part of the Gliome Competence Center Network and the German Cancer Aid. The department uses the latest minimally invasive microsurgical techniques, navigation systems, intraoperative systems, and other advanced technical resources that allow for an optimal therapy result. The department has 84 beds for its patients, 10 of which are intended for intensive care. Medical care is based on an individual approach with due consideration of the patient's specific clinical data and needs. The specialists working at the medical facility always devote enough time to personal communication with their patients and do everything possible so that they receive effective treatment and maintain a decent quality of life.
Department of Adult and Pediatric Neurosurgery, Spinal Surgery
The Department of Adult and Pediatric Neurosurgery, Spinal Surgery offers the full range of services in these fields and specializes in the surgical treatment of diseases of the brain and spinal cord, peripheral nervous system and spine. The important areas of the department's clinical activity also include neuro-oncology, vascular neurosurgery and pediatric neurosurgery. The treatment is provided in four state-of-the-art operating rooms equipped with all the necessary facilities. The department admits about 2,700 inpatients and 4,100 outpatients annually. The team of the department's neurosurgeons is distinguished by high professionalism, and performs many operations using sparing minimally invasive surgical techniques. Navigation systems, intraoperative monitoring devices, 5-ALA fluorescence are successfully used during the surgical treatment. Each operation is carefully planned using advanced navigation devices (under the guidance of CT and MRI scanning). In general, the department's surgeons annually perform more than 4,000 neurosurgical interventions, and therefore they are justifiably proud of their unique clinical experience and treatment results.
Astrocytomas are a group of brain tumors that grow from astroglia cells. There are both benign and malignant neoplasms. Surgery alone may be sufficient to treat 1 or 2 grade astrocytomas if the doctor has managed to remove the brain tumor completely during the operation. For malignant neoplasms, combined treatment is required. It includes surgery and radiation therapy, as well as chemotherapy.
The principles of astrocytoma treatment
Surgery is the main treatment method for any primary brain tumor (with the exception of lymphoma). Usually, in patients with astrocytoma the operation is performed first, and then, if necessary, additional methods of therapy are used.
Less commonly, radiation therapy is the first-line treatment option. This is possible in the following clinical cases:
- The tumor is small and can be destroyed by radiation therapy (radiosurgery and stereotactic radiotherapy are used as a radical method of treatment for neoplasms up to 3.5 cm)
- The tumor is located deep inside the brain tissue, in the hard-to-reach place (its removal will with a high probability lead to the development of severe neurological deficit or even pose a threat to the patient's life)
- The astrocytoma is inoperable (the pathological process has spread significantly at the time of the patient's visit, therefore surgical treatment is not considered)
- The patient has contraindications for surgery, i.e. he has concomitant diseases that make such treatment unsafe
- The patient refuses the operation; in this case the main method of treatment is radiation therapy, regardless of the size of the astrocytoma and the degree of its malignancy
Peculiarities of surgical treatment of astrocytoma
During the surgery, the doctor tries to remove the tumor completely. In this case, it is important not to injure large vessels and nerves, and not to damage functionally important areas of the brain.
Benign astrocytomas usually have distinct boundaries. In most cases they can be removed completely. Malignant astrocytomas grow into the healthy surrounding brain tissue. In German clinics, neuronavigation and fluorescence diagnostics are used to determine their boundaries.
Based on the results of the preoperative examination, the doctor selects the optimal surgical approach. He cuts the skin, performs craniotomy, cuts the dura mater and coagulates the bleeding vessels. The neuronavigation system helps to find the tumor even deep inside the brain and remove it with minimal trauma for healthy tissues.
In German clinics, doctors use fluorescence diagnostics during the malignant astrocytomas treatment. The essence of the method is the use of a special dye, which accumulates selectively in cancer cells. Then, with special lighting, the doctor identifies the abnormal tissue and excises it completely. Fluorescence diagnostics allows:
- Performing more radical removal of the neoplasm
- Doubling the frequency of complete tumor removal
- Reducing the risk of complications development by reducing the volume of excised healthy brain tissue
- Increasing the overall survival rates
In Germany, intraoperative diagnostic methods are used, such as the functional mapping and electrophysiological examinations. They allow identifying functionally important areas of the brain and avoiding their damage during surgery. These techniques are especially important for tumors that are located deep inside the brain.
During the operation, the doctor excises the tumor. If the tumor has low density, the doctor destroys it with ultrasound and sucks it off with an aspirator. The healthcare professional coagulates blood vessels, sutures the dura mater and performs its plastic, if necessary. Then the trepanation hole (skull defect) is closed. For this, doctors use patient’s own tissues or artificial materials. At the final stage of the operation, the scalp is sutured and a bandage is applied.
Within 1-2 days after surgery, CT scan or MRI is performed. These methods of examination make it possible to assess the radicality of the surgical intervention and the severity of cerebral edema, as well as detect possible complications timely.
Additional treatment after surgery
Depending on the radicality of the astrocytoma removal, the degree of its malignancy and the general health state of the patient, the need for additional treatment is determined. Most often, surgery is combined with radiation therapy. Sometimes it is supplemented with chemotherapy.
Brain tumor treatment schemes are as follows:
- After removal of a 1 grade astrocytomas, radiation therapy is usually not required
- After removal of a 2 grade astrocytomas, radiation therapy is required if the doctor has not managed to remove the brain tumor completely
- After removal of a 3 or 4 grade astrocytomas, surgery is always complemented by radiation therapy and chemotherapy
Additional treatments after surgery may have different goals, depending on the type of brain tumor. This can be the prevention of relapse, increasing a patient's life expectancy, increasing the duration of the relapse-free period, etc.
Usually, radiation therapy is performed no earlier than 4-6 weeks after the operation, when the surgical wounds are healed completely. In the exceptional cases, when astrocytoma has a high degree of malignancy and is growing rapidly, radiation therapy can be performed as early as 2 weeks after surgery or even earlier.
Treatment of the recurrent astrocytoma
Both benign and malignant brain tumors can recur. The risk of the disease recurrence differs significantly for different types of astrocytomas. Benign lesions recur rarely if they are removed completely, or the patient underwent radiation therapy after surgery. At the same time, malignant astrocytomas recur sooner or later in most patients.
In order to detect a new brain tumor timely, patients are examined regularly. Usually this is a CT scan or MRI, which is performed every 3-6 months. If the astrocytoma reappears, there are different treatment options. Most often these are:
- Surgery
- Radiation therapy
When the brain tumor is removed again, relapse may occur faster. But still, the operation can give the patient a few more months, and sometimes several years of active life.
Stereotactic radiotherapy or radiosurgery is often the technique of choice for recurrent neoplasms. It allows destroying small tumors safely and comfortably for the patient. The stereotactic radiation therapy provides comparable to surgery disease-free and overall survival.
Why is it better to receive treatment in Germany?
German clinics are equipped with the latest medical technology. Talented neurosurgeons, who use innovative methods of performing operations, work in this country.
Here are several reasons why thousands of patients from all over the world contact clinics in Germany for the treatment of brain tumors.
1. Availability of innovations. In the leading hospitals in Germany, new technologies are developed and quickly introduced into the clinical practice in order to improve the efficiency and safety of brain surgeries. These are modern neuronavigation, fluorescence diagnostics, intraoperative functional studies, etc.
2. Safety of operations. Before the surgery, the patient undergoes MRI, magnetic resonance spectrography or PET, and functional MRI. The doctor receives information about the peculiarities of the tumor location, its proximity to important brain structures, sources of astrocytoma blood supply. While operating on a patient, the neurosurgeon does not damage large vessels and functionally important areas of the brain, which allows achieving a good therapeutic result with a minimal risk of aggravating neurological deficit.
3. Performing radical operations. In Germany, even malignant astrocytomas are removed completely in most patients. Doctors find all parts of the tumor using both neuronavigation equipment and fluorescence diagnostics. After the complete removal of a benign brain tumor, the patient may not receive radiation therapy. This leads to the reduced health risks, as well as time and cost savings. After complete removal of malignant tumors, patient survival and the duration of the relapse-free period are better.
4. The latest equipment. German clinics use the latest neuronavigation systems with frameless stereotaxis, modern neurosurgical tables and instruments, ultrasonic aspirators, operating microscopes, etc.
5. High-precision and safe irradiation. Radiation therapy in Germany is carried out on stereotaxic devices and linear accelerators of the latest generations. They provide precise targeting of beams to the brain tumor from different angles, so healthy tissues receive minimal irradiation dose. Stereotactic radiation therapy in Germany can be performed without using a frame that is screwed onto the patient's skull.
The ratio of quality and cost of treatment in Germany is one of the best in the world. It is more expensive to receive treatment in German clinics than in Turkey or India, but the level of medicine is also higher here. Prices in Germany are lower than in the USA or Japan, with comparable quality of medical services.
Treatment in Germany at affordable prices with Booking Health
Use the Booking Health service to receive information about the main hospitals, doctors and find out the cost of treatment in Germany. All the leading German hospitals in which it is possible to cure an astrocytoma of the brain with the help of surgery are presented on the Booking Health portal.
You may compare the cost of treatment in Germany in different clinics and book a medical program at the best price. Booking Health will arrange a trip abroad for you. Services and benefits of Booking Health include:
- Choosing a clinic that specializes in astrocytoma diagnosis making and surgery, performs operations efficiently and safely
- Direct communication with a neurosurgeon
- Reducing the waiting time for astrocytoma treatment start and making an appointment at a convenient date
- Reducing the cost of treatment in Germany; prices are reduced due to avoiding the additional coefficients for foreign patients
- Control of the cost of medical procedures and return of unspent funds after the completion of treatment of a brain tumor
- Preparation of a medical program without the need to repeat previously performed diagnostic procedures
- Communication with the clinic after astrocytoma treatment completion
- Purchase and sending medical products
- Arranging additional procedures for the diagnosis making or treatment abroad
Booking Health specialists provide high-quality service. We will book a hotel and air tickets for you, organize a transfer from the airport to the hospital and back.
