Abstract: Objective To investigate the efficacy of neuronavigation combined with fluorescein sodium (FLS) in intraoperative imaging⁃assisted resection of brain metastases. Methods The clincal data of 125 surgical patients with brain metastasis (BM) treated in neurosurgery department of Guangxi Medical University Cancer Hospital from January 2019 to October 2022 were retrospectively analyzed. Among these BM patients, 87 patients who underwent neuronavigation combined with FLS intraoperative imaging⁃assisted resection were classified into the neuronavigation combined with FLS group, and 38 patients who underwent surgical resection under neuronavigation alone were classified into the neuronavigation group. The degree of tumor resection, surgical time, blood bleeding, complications, and 1⁃month postoperative karnofsky scale (KPS) scores were compared between the two groups. Results The total resection rate of the neuronavigation combined with FLS group was 85.1%, which was significantly higher than that (65.8%) of the neuronavigation group (P=0.028). After adjusting for possible confounding factors, the total resection rate of the neuronavigation combined with FLS group was 1.849 times higher than that of the neuronavigation group (OR=1.849, 95% CI: 1.130~3.026, P=0.014). The KPS scores of the neuronavigation combined with FLS group was significantly higher than that of the neuronavigation group at 1 month after surgery (78.96±13.81 vs 65.00±18.56, P<0.001). The difference between the two groups was statistically significant (P<0.001). The surgical time and blood bleeding of the neuronavigation combined with FLS group were lower than those of the neuronavigation group (all P<0.05), though no significant difference in complications was found between the two groups (P>0.05). Conclusions Neuronavigation combined with FLS assisted BM resection surgery can improve the total tumor resection rate and the short⁃term life quality of patients with safety.

Key words: Brain metastasis')">Brain metastasis, Neuronavigation, Fluorescein Sodium, Neurosurgery