Fully Endoscopic Transforaminal–Transchoroidal Approach for Tectal Area Tumor Removal

Tirado-Caballero, Jorge; Rivero-Garvía, Mónica; González-Pombo, Marta; Cárdenas-Ruiz-Valdepeñas, Eugenio; Kaen, Ariel; Márquez-Rivas, Javier

doi:10.1016/j.wneu.2019.12.106

Cited by 12 publications

(16 citation statements)

References 19 publications

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“…We applied the thrombin matrix over the germinal matrix bleeding point after finishing the lavage. This technique has shown its usefulness for controlling IVHs in previous reports [21]. No rebleeding were diagnosed in our series once we started performing this technique, so we consider it was useful for this purpose.…”

Section: Discussionsupporting

confidence: 55%

Technical Nuances in Neuroendoscopic Lavage for Germinal Matrix Hemorrhage in Preterm Infants: Twenty Tips and Pearls after More than One Hundred Procedures

et al. 2021

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Introduction: Posthemorrhagic hydrocephalus in preterm infants is a serious entity related to high mortality and morbidity. Neuroendoscopic lavage (NEL) is a suitable alternative for the management of this pathology. However, as with every endoscopic technique, it requires some experience and several cases to master. Methods: We present a descriptive study of some technical nuances, tips, and tricks that have been learned in the last 8 years with over a hundred NELs performed in preterm infants. These variations are classified into 3 categories according to their temporal relationship with the surgical procedure: preoperative stage, intraoperative stage, and postoperative stage. We include a brief description of each one and the reasons why they are included in our current clinical practice. Results: Twenty tips and pearls were described in detail and are reported here. Preoperative, intraoperative, and postoperative variations were exposed and related to the most frequent complications of this procedure: infection, cerebrospinal fluid leak, and rebleeding. Conclusions: NEL is a useful technique for the management of germinal matrix hemorrhage in preterm infants. These technical nuances have improved the results of our technique and helped us to prevent complications related to the procedure.

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Section: Discussionsupporting

confidence: 55%

Technical Nuances in Neuroendoscopic Lavage for Germinal Matrix Hemorrhage in Preterm Infants: Twenty Tips and Pearls after More than One Hundred Procedures

et al. 2021

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“…This finally resulted in nine studies, which we included in the analysis (Fig. 2) [2,[14][15][16][17][18][19][20][21]. These studies consisted of 6 case series [2,15,[18][19][20][21] and three case reports [14,16,17].…”

Section: Resultsmentioning

confidence: 99%

“…2) [2,[14][15][16][17][18][19][20][21]. These studies consisted of 6 case series [2,15,[18][19][20][21] and three case reports [14,16,17]. A total of 40 patients were analyzed in the included studies, of whom 19 (47.5%) were children (Table 1).…”

Section: Resultsmentioning

confidence: 99%

Resection of brain lesions with a neuroendoscopic ultrasonic aspirator — a systematic literature review

et al. 2022

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The development of minimally invasive neuroendoscopy has advanced in recent years. The introduction of the neuroendoscopic ultrasonic aspirator (NUA) increased the treatment spectrum of neuroendoscopy. This review aimed to present a systematic overview of the extent of resection, lesion characteristics, technical aspects, complications, and clinical outcomes related to using the NUA. Articles were identified by searching the PubMed/Medline, Embase, and Web of Science database through June 2022 with restriction to the last 20 years. We included case series, case reports, clinical trials, controlled clinical trials, meta-analyses, randomized controlled trials, reviews, and systematic reviews written in English. Studies reporting on endonasal approach or hematoma evacuation using the NUA were excluded. The references of the identified studies were reviewed as well. Nine full-text articles were included in the analysis, with a total of 40 patients who underwent surgery for a brain tumor using NUA. The most common underlying pathology treated by NUA was colloid cyst (17.5%), pilocytic astrocytoma (12.5%), subependymal giant cell astrocytoma (7.5%), subependymoma (7.5%), and craniopharyngioma (7.5%). Complete or near-total resection was achieved in 62.5%. The most frequently reported postoperative complication was secondary hydrocephalus (10%), meningitis/-encephalitis (7.5%), cognitive impairment (7.5%), and subdural hygroma (7.5%). In one case (2.5%), surgery-related death occurred due to a severe course of meningoencephalitis. According to the preliminary data, NUA seems to be a safe and efficient minimally invasive alternative to conventional microscopic resection of brain tumors. Further studies to investigate advantages and disadvantages of using the NUA are needed.

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“…Should resection be deemed necessary, it has been reported that a paramedian, infratentorial-supracerebellar, transcollicular approach provides safe access to the posterior and middle tentorial incisura [1,12,26]. However, recent success has been reported in use of a fully endoscopic transforaminal-transchoroidal approach to tectal plate [30]. This approach allowed for gross total resection of tectal gliomas in two adult patients through use of an endoscopic aspirator.…”

Section: Surgical Resectionmentioning

confidence: 99%

Management strategies for pediatric patients with tectal gliomas: a systematic review

et al. 2021

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Pediatric tectal gliomas generally have a benign clinical course with the majority of these observed radiologically. However, patients often need treatment for obstructive hydrocephalus and occasionally require cytotoxic therapy. Given the lack of level I data, there is a need to further characterize management strategies for these rare tumors. We have therefore performed the first systematic review comparing various management strategies. The literature was systematically searched from January 1, 2000, to July 30, 2020, to identify studies reporting treatment strategies for pediatric tectal gliomas. The systematic review included 355 patients from 14 studies. Abnormal ocular findings—including gaze palsies, papilledema, diplopia, and visual field changes—were a common presentation with between 13.6 and 88.9% of patients experiencing such findings. CSF diversion was the most performed procedure, occurring in 317 patients (89.3%). In individual studies, use of CSF diversion ranged from 73.1 to 100.0%. For management options, 232 patients were radiologically monitored (65.4%), 69 received resection (19.4%), 30 received radiotherapy (8.4%), and 19 received chemotherapy (5.4%). When examining frequencies within individual studies, chemotherapy ranged from 2.5 to 29.6% and radiotherapy ranged from 2.5 to 28.6%. Resection was the most variable treatment option between individual studies, ranging from 2.3 to 100.0%. Most tectal gliomas in the pediatric population can be observed through radiographic surveillance and CSF diversion. Other forms of management (i.e., chemotherapy and radiotherapy) are warranted for more aggressive tumors demonstrating radiological progression. Surgical resection should be reserved for large tumors and/or those that are refractory to other treatment modalities.

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Fully Endoscopic Transforaminal–Transchoroidal Approach for Tectal Area Tumor Removal

Cited by 12 publications

References 19 publications

Technical Nuances in Neuroendoscopic Lavage for Germinal Matrix Hemorrhage in Preterm Infants: Twenty Tips and Pearls after More than One Hundred Procedures

Technical Nuances in Neuroendoscopic Lavage for Germinal Matrix Hemorrhage in Preterm Infants: Twenty Tips and Pearls after More than One Hundred Procedures

Resection of brain lesions with a neuroendoscopic ultrasonic aspirator — a systematic literature review

Management strategies for pediatric patients with tectal gliomas: a systematic review

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