TY - JOUR AU - Lages, Gustavo Veloso; Oliveira Júnior, José Oswaldo TI - Mesencephalotomy, How I Do It: Analysis of 34 Cases TT - Mesencefalotomia, como eu faço: análise de 34 casos SN - 0103-5355 SN - 2359-5922 PY - 2019 JF - Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery LA - EN VL - 38 IS - 03 SP - 227 EP - 235 ET - 2016/11/24 DA - 2019/09/23 KW - pain KW - functional neurosurgery KW - facial pain KW - cancer pain KW - ablative procedure AB - The present paper aims to demystify the use of rostral mesencephalic reticulotomy (mesencephalotomy) in the treatment of chronic pain in cancer patients. A retrospective review of the medical records from the Central Pain and Stereotaxy Department of the A. C. Camargo Cancer Center, São Paulo, state of São Paulo, Brazil, between 2005 and 2012, was performed. Surgical indication was restricted to patients with cancer pain refractory to etiological and symptomatic treatments, > 2 months of expected survival, preserved cognition, and absence of coagulation disorders, of systemic infection, and of intracranial hypertension. We have selected 34 patients, with an average follow-up of 9.4 months, an average age of 54.3 years-old, and an average follow-up time until death of 6.4 months. Lung cancer was the most frequent diagnosis. Satisfactory and immediate pain relief was achieved in 91% of the cases, and 83% of these patients had no relapses. Among the complications, ocular movement disorder was the most frequent, but often transient. Permanent disturbances occurred in 8.8% of the cases (diplopia, rubral tremor, and paresthesia). Compared to the pharmacological treatment, mesencephalotomy was economically feasible, more effective, and improved quality of life. According to the data presented, it can be concluded that mesencephalotomy is a viable procedure for cancer pain control in selected cases. PB - Thieme Revinter Publicações Ltda DO - 10.1055/s-0036-1594260 UR - http://www.thieme-connect.de/products/ejournals/abstract/10.1055/s-0036-1594260 ER -