{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T14:11:32Z","timestamp":1789567892730,"version":"build-2803163510"},"reference-count":58,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"\n Background<\/jats:title>\n Neuronavigational surgery has become a cutting-edge technique that improves surgical accuracy, increases tumor excision rates, and preserves neurological function in glioma patients.<\/jats:p>\n <\/jats:sec>\n \n Aim<\/jats:title>\n This meta-analysis was conducted to assess the efficacy of neuronavigational and advanced imaging-assisted surgery compared to traditional glioma surgery.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n In total, 30 articles published between 2006 and 2026, including randomized controlled trials, prospective cohort studies, retrospective cohort studies, and case series, were evaluated. The intervention involved intraoperative MRI (iMRI), ultrasound-guided navigation, functional neuronavigation, and other advanced navigational technologies. Meta-analysis was carried out using random effects models with inverse variance to calculate pooled odds ratios (ORs), 95% confidence intervals (CIs),\n I<\/jats:italic>\n 2<\/jats:sup>\n and\n \u03c4<\/jats:italic>\n 2<\/jats:sup>\n measures of heterogeneity, and publication bias using funnel plots and Egger\u2019s regression test. The risk of bias was assessed through the Cochrane RoB 2 for 7 randomized controlled trials and ROBINS-I for 23 observational studies.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Overall analysis demonstrated significant improvement with neuronavigation-guided surgery (OR\u202f=\u202f2.37, 95% CI: 2.05\u20132.74,\n p<\/jats:italic>\n &lt;\u202f0.05;\n I<\/jats:italic>\n 2<\/jats:sup>\n =\u202f22.8%). Subgroup analyses showed significant benefits for iMRI-guided surgery (OR\u202f=\u202f2.49, 95% CI: 1.92\u20133.23,\n z<\/jats:italic>\n =\u202f6.88,\n I<\/jats:italic>\n 2<\/jats:sup>\n =\u202f22.6%,\n \u03c4<\/jats:italic>\n 2<\/jats:sup>\n =\u202f0.0428,\n p<\/jats:italic>\n =\u202f0.2286), ultrasound-based navigation (OR\u202f=\u202f1.97, 95% CI: 1.47\u20132.66,\n z<\/jats:italic>\n =\u202f4.50,\n I<\/jats:italic>\n 2<\/jats:sup>\n =\u202f4.9%,\n \u03c4<\/jats:italic>\n 2<\/jats:sup>\n =\u202f0.0084,\n p<\/jats:italic>\n =\u202f0.3685), functional neuronavigation (OR\u202f=\u202f2.11, 95% CI: 1.59\u20132.80,\n z<\/jats:italic>\n =\u202f5.17,\n I<\/jats:italic>\n 2<\/jats:sup>\n =\u202f0%), advanced navigation technologies (OR\u202f=\u202f2.33, 95% CI: 1.67\u20133.25,\n z<\/jats:italic>\n =\u202f4.99,\n I<\/jats:italic>\n 2<\/jats:sup>\n =\u202f16.4%), and other specialized techniques (OR\u202f=\u202f2.16, 95% CI: 1.63\u20132.86,\n z<\/jats:italic>\n =\u202f5.34,\n I<\/jats:italic>\n 2<\/jats:sup>\n =\u202f8.3%). Leave-one-out analysis confirmed the stability of the pooled effect, with minimal changes after exclusion of individual studies.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Neuronavigation-based and image-enhanced surgical procedures can significantly improve glioma surgery outcomes, with low heterogeneity and strong pooled effects. Large-scale multicenter studies are needed in order to prove their efficacy in the long term.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fneur.2026.1893712","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T13:55:46Z","timestamp":1789566946000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Neuronavigation-guided precise resection versus conventional glioma surgery: a meta-analysis of clinical outcomes"],"prefix":"10.3389","volume":"17","author":[{"given":"Shuanglei","family":"Guo","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Huaihe Hospital of Henan University","place":["Kaifeng, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kang","family":"He","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Huaihe Hospital of Henan University","place":["Kaifeng, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bingjian","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Huaihe Hospital of Henan University","place":["Kaifeng, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaobing","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Huaihe Hospital of Henan University","place":["Kaifeng, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Honglin","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Huaihe Hospital of Henan University","place":["Kaifeng, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenjiang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Huaihe Hospital of Henan University","place":["Kaifeng, 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