Clinical trial NCT07005869: Brachial Plexus Tumors; Pathological Types and Surgical Approaches: Multi Center Experience
Official title: Brachial Plexus Tumors; Pathological Types and Surgical Approaches: Multi Center Experience
Study type: INTERVENTIONAL
Overall status: NOT_YET_RECRUITING
Phase: NA
Conditions: Brachial Plexus Tumors
Lead sponsor: Assiut University
Sponsor class: OTHER
First posted: 2025-06-05
Enrollment: 15
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: Brachial plexus tumors, are rare, present significant challenges due to their intricate anatomical location and potential impact on upper limb function. These tumors arise from nerve sheath cells, including either benign schwannomas and neurofibromas, or as malignant peripheral nerve sheath tumors (MPNSTs), which require early diagnosis and intervention to improve patient outcomes (1). Surgical resection remains the primary treatment modality, aiming to alleviate symptoms and prevent further neurological compromise.

Detailed description: Brachial plexus tumors, are rare, present significant challenges due to their intricate anatomical location and potential impact on upper limb function. These tumors arise from nerve sheath cells, including either benign schwannomas and neurofibromas, or as malignant peripheral nerve sheath tumors (MPNSTs), which require early diagnosis and intervention to improve patient outcomes (1). Surgical resection remains the primary treatment modality, aiming to alleviate symptoms and prevent further neurological compromise.

The choice of surgical approach is influenced by the tumor's size, location, and relationship with surrounding neurovascular structures. Anterior approaches, including supraclavicular and infraclavicular incisions, provide excellent exposure for lesions in the upper and middle parts of the plexus, whereas posterior approaches are preferred for deep-seated or retroclavicular tumors (2). Intraoperative neurophysiological monitoring (IONM) has significantly improved surgical precision, reducing the risk of postoperative deficit .

Advancements in microsurgical techniques, such as nerve grafting and nerve transfers, have improved functional recovery in patients undergoing brachial plexus tumor resection. Early intervention and meticulous dissection help preserve nerve function and minimize postoperative deficits (3). Minimally invasive techniques, including endoscopic and robotic-assisted approaches, are being explored to reduce morbidity and improve surgical precision (4).

Despite progress in surgical management, challenges remain, particularly in cases of malignant tumors where complete resection may not be feasible. Adjuvant therapies, including radiation and chemotherapy, are increasingly utilized for malignant brachial plexus tumors to enhance local control and reduce recurrence rates (5). Long-term follow-up and rehabilitation play a crucial role in optimizing functional recovery, emphasizing the need for a multidisciplinary approach (6).

This review aims to analyze the indications, techniques, and outcomes of different surgical approaches for brachial plexus tumors, providing insights into optimizing patient outcomes while minimizing surgical morbidity.

Eligibility criteria: Inclusion Criteria:

.Patients diagnosed with brachial plexus tumors confirmed through imaging

.Age of Patients: Any age .

.patients who are fit for surgery .

Exclusion Criteria:

. Patients with non-tumorous brachial plexus pathologies (e.g., trauma, inflammation).

.Patients with incomplete medical records or lost follow-up data.

.Patients with recurrent tumors previously treated.

.Patients who are unfit for surgery.

Primary outcomes:
measure: 1-motor power and sensory improvment
timeFrame: 2 years
measure: Radiological out come
timeFrame: 2 years
Secondary outcomes:
Other outcomes:
Locations:
Study officials:
affiliation: Assiut University
name: Mohamed Ab khallaf, MD
role: STUDY_DIRECTOR
References: