Glioma has been called: “the most challenging intracranial tumor” for the following reasons: 1. glioma is the most common intracranial tumor; 2. it is difficult to be eradicated like other malignant tumors. Wei Lin, Department of Neurosurgery, Qianfoshan Hospital, Shandong Province, China My teacher, Prof. Zhang Qinglin, a famous neurosurgical expert, has surgically removed 543 cases of cerebral hemispheric gliomas in the past 50 years, of which 112 cases were in the functional area and the deep part of the hemisphere, with 59 cases of total and near-total resection of the tumor (52.68%) and an operative mortality rate of 2.68%, and 431 cases were in the non-functional area, with 359 cases of total and near-total resection of the tumor (83.29%), and an operative mortality rate of 0.93%. surgical mortality rate of 0.93%, and the total surgical mortality rate of hemispheric glioma was 1.29%. The total mortality rate of hemispheric glioma surgery was 1.29%. Now, we will talk about our personal experience and understanding in combination with the typical cases, and exchange with colleagues, and please correct us if there are any inappropriate points. u Cerebral resection: for gliomas confined to the brain, especially frontal, temporal and occipital tumors, the whole brain together with the tumor should be resected. If the functional area is not damaged in this kind of surgery, a better effect can be obtained, and even a curative effect can be achieved (Cases 1 and 2). u Total resection along the edge of the tumor: Usually, it is only total resection under the naked eye and hand feeling, and the efficacy is better when there is slight damage or no damage to the functional area. u Intracapsular resection: if the tumor is cystic and the tumor nodule is located in the wall of the capsule (tumor inside the capsule), only the capsule fluid needs to be eliminated, total resection of the tumor nodule is required, and the wall of the capsule does not need to be completely removed, and the efficacy of the treatment is better; however, when the capsule lumen is inside the tumor (capsule inside the tumor), the tumor must be removed as much as possible in order to achieve a better therapeutic effect, or the efficacy of the treatment is not good. u Near-total or major resection of the tumor: near-total or major resection of the tumor is definitely less effective than total resection. u If the tumor is only partially resected, biopsy, external decompression, internal decompression, etc., the effect is the worst. Since the early 1970s, my principle of resection of non-functional gliomas is to strive to resect the tumor outside of the tumor area about 1 to 2 cm together (tumor + surrounding brain tissue), and achieved a better therapeutic effect. In the early 1990s, based on the analysis and follow-up of a large number of cases, we summarized and wrote an article on “Radical Glioma Surgery and Its Clinical Application”, which was summarized as follows: total resection of non-functional tumors plus resection of recurrence-prone part of the brain tissue to improve the therapeutic efficacy, and put forward the Criterion of Brain Resection (CBS). Criterion of brain lobectomy u Frontal: from the frontal pole down to the pterygoid sinus, out to the lateral fissure, and back to 2 cm from the precentral gyrus, including the frontal horn and the medial brain tissue (Case 3). u Temporal: from the temporal pole down to the pterygoid sinus, out to the lateral fissure, and back to 2 cm from the precentral gyrus. u Temporal ~: from the temporal pole up to the lateral fissure, down to the base of the middle cranial fossa, and inward to the pars pallidus, including the temporal horn and deltoid region (Case 2) . u Occipital ~: from the occipital ~ to the lower part of the parietal ~, including the inner and lower parts of the occipital horn and deltoid region (Case 1) . Historically, there has been no uniform specification for the surgical approach to gliomas in the functional areas of the cerebral hemispheres, with different authors having different opinions, due to the contradiction between resection of the tumor and the residual cerebral functional deficit. Many scholars believe that it is difficult to improve the therapeutic efficacy of malignant tumors regardless of the surgical approach, and that although total or near-total resection of the tumor prolongs the survival period, the brain function deficit is obvious and the quality of life is poor, so partial or major resection is often adopted, and then the hope of improving the therapeutic efficacy is pinned on radiation or chemotherapy, which ultimately fails to solve the above contradiction appropriately. Thus, the surgical approach to glioma is a hot topic of concern and needs to be discussed. u Incision from the non-functional area to the tumor area, total or near-total resection of the tumor along its fleshly pseudo-boundary, with or without opening of the ventricles, depending on the tumor invasion. u Direct access to the tumor area from the functional area, (especially suitable for those whose cortex has been tumorized or whose tumor is very close to the cortex) total or near-total resection of the cortex and the tumor at the same time. u Access to the tumor from a functional or non-functional area, with major or partial resection of the tumor and simultaneous external and/or internal decompression. u Depending on the depth of the tumor location, biopsy or partial excision is not enough to prolong the patient’s survival and quality of life. It has been proved in practice that although there is a certain deterioration in the function of patients who have undergone total or near-total resection and radiation therapy for functional zone tumors, some of the patients can get better after surgery and their survival period is relatively prolonged, which is worth our consideration and application. Comparison of the above four types of resection of functional brain tumors tells us that the degree of preservation of brain function and prolongation of survival are at the expense of each other. We believe that a sound way to solve the contradiction is to preserve brain function under the premise of removing as much tumor as possible and prolonging survival.