Flexible Neuroendoscopic Diagnosis and Management of Ventricular Tumors: A Retrospective Cohort Study

Torres-Corzo, Jaime Gerardo; Islas-Aguilar, Mario Alberto; Cerecedo-López, Christian D.

doi:10.1016/j.wneu.2018.07.023

Cited by 7 publications

(3 citation statements)

References 25 publications

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“…In contrast, an endoscopic approach allows procurance of a tissue sample and treatment of hydrocephalus during one surgical procedure. The diagnostic yield of an endoscopic biopsy was reported to be at 81.1 to 100% [ 2 , 3 , 28 , 33 , 37 ]. In addition to this diagnostic yield rate, the rate of accordance of the first histological result after biopsy with the second histological results after a later resection (or repeated biopsy) represents the diagnostic accuracy rate [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

Management of pineal region tumors in a pediatric case series

et al. 2020

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Pineal region tumors commonly present with non-communicating hydrocephalus. These heterogeneous histological entities require different therapeutic regimens. We evaluated our surgical experience concerning procurance of a histological diagnosis, management of hydrocephalus, and choice of antitumoral treatment. We analyzed the efficacy of neuroendoscopic biopsy and endoscopic third ventriculocisternostomy (ETV) in patients with pineal region tumors between 2006 and 2019 in a single-center retrospective crosssectional study with regard to diagnostic yield, hydrocephalus treatment, as well as impact on further antitumoral management. Out of 28 identified patients, 23 patients presented with untreated hydrocephalus and 25 without histological diagnosis. One patient underwent open biopsy, and 24 received a neuroendoscopic biopsy with concomitant hydrocephalus treatment if necessary. Eighteen primary ETVs, 2 secondary ETVs, and 2 ventriculoperitoneal shunts (VPSs) were performed. Endoscopic biopsy had a diagnostic yield of 95.8% (23/24) and complication rates of 12.5% (transient) and 4.2% (permanent), respectively. ETV for hydrocephalus management was successful in 89.5% (17/19) with a median follow-up of more than 3 years. Following histological diagnosis, 8 patients (28.6%) underwent primary resection of their tumor. Another 9 patients underwent later-stage resection after either adjuvant treatment (n = 5) or for progressive disease during observation (n = 4). Eventually, 20 patients received adjuvant treatment and 7 were observed after primary management. One patient was lost to follow-up. Heterogeneity of pineal region tumor requires histological confirmation. Primary biopsy of pineal lesions should precede surgical resection since less than a third of patients needed primary surgical resection according to the German pediatric brain tumor protocols. Interdisciplinary decision making upfront any treatment is warranted in order to adequately guide treatment.

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Section: Discussionmentioning

confidence: 99%

Management of pineal region tumors in a pediatric case series

et al. 2020

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“…Out of the 46 case series with 3739 patients, 12 studies included adult population [7,11,13,24,25,34,35,39,40,49,50], 14 studies included pediatric population [1,4,7,8,12,29,33,45,46,51,58,60], and 20 studies included patients from both groups [2, 10, 15, 19, 21, 23, 29, 30, 37, 41-44, 47, 52, 53, 55, 56, 59]. Regarding flexible ETV, 10 studies [23,34,35,41,42,48,52,53,57,58] reported outcomes with a total of 821 patients, of whom 38 were adults, 126 were pediatric, and 657 were a mixture of adult and pediatric populations. For rigid ETV, 37 studies [1-4, 6-8, 10-13, 15, 18-21, 24, 25, 29, 30, 33, 37, 39, 40, 43-47, 49-51, 54-57, 59, 60] reported outcomes for a total of 2918 patients, of whom 1018 were adults, 747 were pediatric, and 1153 patients were a mixture of adult and pediatric populations.…”

Section: Search Results and Characteristicsmentioning

confidence: 99%

“…Out of the 46 case series with 3739 patients, 12 studies included adult population [ 7 , 11 , 13 , 24 , 25 , 34 , 35 , 39 , 40 , 49 , 50 ], 14 studies included pediatric population [ 1 , 4 , 7 , 8 , 12 , 29 , 33 , 45 , 46 , 51 , 58 , 60 ], and 20 studies included patients from both groups [ 2 , 10 , 15 , 19 , 21 , 23 , 29 , 30 , 37 , 41 – 44 , 47 , 52 , 53 , 55 , 56 , 59 ]. Regarding flexible ETV, 10 studies [ 23 , 34 , 35 , 41 , 42 , 48 , 52 , 53 , 57 , 58 ] reported outcomes with a total of 821 patients, of whom 38 were adults, 126 were pediatric, and 657 were a mixture of adult and pediatric populations. For rigid ETV, 37 studies [ 1 – 4 , 6 – 8 , 10 – 13 , 15 , 18 – 21 , 24 , 25 , 29 , 30 , 33 , 37 ,…”

Section: Resultsmentioning

confidence: 99%

Efficacy and safety of flexible versus rigid endoscopic third ventriculostomy in pediatric and adult populations: a systematic review and meta-analysis

et al. 2021

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Endoscopic third ventriculostomy (ETV) is a well-established surgical procedure for hydrocephalus treatment, but there is sparse evidence on the optimal choice between flexible and rigid approaches. A meta-analysis was conducted to compare efficacy and safety profiles of both techniques in pediatrics and adults. A comprehensive search was conducted on PubMED, EMBASE, and Cochrane until 11/10/2019. Efficacy was evaluated comparing incidence of ETV failure, while safety was defined by the incidence of perioperative complications, intraoperative bleedings, and deaths. Random-effects models were used to pool the incidence. Out of 1365 studies, 46 case series were meta-analyzed, yielding 821 patients who underwent flexible ETV and 2918 who underwent rigid ETV, with an age range of [5 days–87 years]. Although flexible ETV had a higher incidence of failure in adults (flexible: 54%, 95%CI: 22–82% vs rigid: 20%, 95%CI: 22–82%) possibly due to confounding due to etiology in adults treated with flexible, a smaller difference was seen in pediatrics (flexible: 36%, pediatric: 32%). Safety profiles were acceptable for both techniques, with a certain degree of variability for complications (flexible 2%, rigid 18%) and death (flexible 1%, rigid 3%) in pediatrics as well as complications (rigid 9%, flexible 13%), death (flexible 4%, rigid 6%) and intra-operative bleeding events (rigid 6%, flexible 8%) in adults. No clear superiority in efficacy could be depicted between flexible and rigid ETV for hydrocephalus treatment. Safety profiles varied by age but were acceptable for both techniques. Well-designed comparative studies are needed to assess the optimal endoscopic treatment option for hydrocephalus.

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