{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T06:03:42Z","timestamp":1790661822438,"version":"4.1.0"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"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. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Sodium fluorescein (SF) used with a YELLOW 560-nm filter may improve intraoperative visualization of contrast-enhancing brain tumors, but pediatric evidence remains limited. We assessed the feasibility, safety, and surgical outcomes of SF-guided resection in a single-center pediatric cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively analyzed pediatric brain tumor resections performed between 2015 and 2023 using a before-and-after design based on the institutional introduction of SF. SF-guided procedures were compared with historical white-light controls. Inclusion required a contrast-enhancing intracranial tumor considered amenable to gross total resection (GTR). SF was administered intravenously at 2\u2005mg\/kg. The primary endpoint was radiographically confirmed GTR within 72\u2005h; operative duration, postoperative course, complications, and follow-up outcomes were secondary exploratory endpoints. Exploratory multivariable logistic regression for GTR included SF use, age, sex, and supra- vs. infratentorial location. Operative duration was compared using a two-sided Mann\u2013Whitney\n                      <jats:italic>U<\/jats:italic>\n                      -test.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 60 procedures in 50 patients, 32 were performed with SF and 28 without SF. GTR was achieved in 93.8% of SF-guided and 71.4% of non-SF procedures (absolute difference, 22.4 percentage points; Fisher's exact\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.035). In exploratory multivariable analysis, SF use was associated with GTR (adjusted odds ratio 5.890, 95% confidence interval 1.091\u201331.080;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.039). In an unadjusted exploratory analysis, operative duration was lower with SF [median 191.5\u2005min (IQR 148.25\u2013264.25) vs. 249.5\u2005min (IQR 184.00\u2013306.75);\n                      <jats:italic>U<\/jats:italic>\n                      \u2009=\u2009303,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.032]. No SF-related adverse reactions occurred. Fluorescence was documented in 20\/32 SF-guided procedures and was positive in 17\/20 of those cases.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Low-dose SF was safe and feasible and was associated with higher GTR rates and lower operative duration. However, the historical-control design, limited number of non-GTR outcomes, heterogeneous tumors, baseline differences, unequal follow-up, and residual confounding preclude causal or long-term oncological conclusions. Prospective validation is required.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1875948","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T05:46:48Z","timestamp":1790660808000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Safety and surgical outcomes of sodium fluorescein-guided pediatric brain tumor surgery: a retrospective before-and-after single-center cohort study"],"prefix":"10.3389","volume":"13","author":[{"given":"Christian","family":"Ott","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University Medical Center Regensburg","place":["Regensburg, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Hebeler","sequence":"additional","affiliation":[{"name":"Universitat Regensburg","place":["Regensburg, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tommaso","family":"Araceli","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Medical Center Regensburg","place":["Regensburg, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Greiner","sequence":"additional","affiliation":[{"name":"Department of Radiology, University Medical Center Regensburg","place":["Regensburg, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Rosengarth","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Medical Center Regensburg","place":["Regensburg, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Proescholdt","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Medical Center Regensburg","place":["Regensburg, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nils-Ole","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Medical Center Regensburg","place":["Regensburg, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Siller","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Medical Center Regensburg","place":["Regensburg, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"6099","DOI":"10.3390\/CANCERS13236099","article-title":"Childhood malignant brain tumors: balancing the bench and bedside","volume":"13","author":"Thorbinson","year":"2021","journal-title":"Cancers (Basel)"},{"key":"B2","doi-asserted-by":"publisher","first-page":"i1","DOI":"10.1093\/neuonc\/noaf194","article-title":"CBTRUS 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