Nonanastomotic indirect bypass surgery in the surgical treatment of malignant glialtumors

The primary treatment of malignant glial tumors is surgical intervention for maximally reducing and/or total removing of tumors. the purpose of this report was to describe pial sinangiosis or indirect nonanastomotic bypass surgery for diversion of blood brain barrier for enhancing of systemic blood-brain tissue penetration in the enhancing of the effect of chemotherapy. the other purposes are the increasing of oxygen and metabolic product providing, enhancing of radiation sensitivity, and stabilization of brain tissue around the tumor bed for reducing of malignant transformation. we used the technique of indirect non anastamotic by-pass surgery technique during the surgical treatment of malignant glial tumors. preoperative and postoperative magnetic resonance images were obtained to evaluate peri-lesional edema and residual complications. this technique was used in three cases of malignant glial tumors. there were no operative mortality and morbidity related to this technique. this technique may be used during the surgical treatment of malignant glial tumors to enhance penetration of chemotherapeutic agents, increasing of radiation sensitivity and providing of tissue stability.