Microsurgical resection of tumors of the lateral and third ventricles: operative corridors for difficult-to-reach lesions

Çıkla, Ulaş; Swanson, Kyle I.; Tümtürk, Abdülfettah; Keser, Neşe; Uluç, Kutluay; Cohen-Gadol, Aaron; Başkaya, Mustafa K.

doi:10.1007/s11060-016-2126-9

Cited by 71 publications

(32 citation statements)

References 53 publications

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“…The pоint is that chоrоidal dissеctіоn is done at the middle and posterior compartment of the roof of the thіrd ventricle (the internal cerebral veins are closest). Risk is due to the not enough spаce to conduct this dіssection [13,14]. Anterior choroidal dissection proceeded to posterior edge of the foramen of Monro would eliminate this risk as internal cerebral veins diverge of the foramen of Monro to the sides.…”

Section: Resultsmentioning

confidence: 99%

Peculiarities of the third ventricle surgery in endoscopic frontal transcortical approach

et al. 2019

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To analyze the results of surgical treatment patients with the third ventricular pathology. Objective. To improve methods of transchoroidal dissection. To make enough space for surgery of the third ventricle by expanding the foramen of Monro. To reduce the risk of surgical treatment in the pathology at the posterior compartment of the third ventricle. Materials and methods. The results of treatment of 27 patients with tumors and colloid cysts to the third ventricle were analyzed. In all 27 patients endoscopic frontal transcortical approach was perfomed. In 24 cases of them extended anterior choroidal dessection was perfomed (transchoroidal and transforaminal approach); in 3 cases-transcortical transforaminal approach (without choroidal dissection). In all case there was fully endoscopic removal (100 %). Results. Gross total resection was achieved in 14 cases, subtotal resection-in 13 cases. Karnofsky Performance Scale in the postoperative period demonstrated ≥ 70 points in all patients. Complications occurred in 4 patients (14.8 %). No postoperative mortality was observed. Conclusions. 1. Transcortical transforaminal approach can be used for the pathology in the anterior compartment of the third ventricle. 2. Transcortical transchoroidal approach can be perfomed for the pathology, which localized or spread into the posterior part of the third ventricle. 3. Anterior transchoroidal dissection can be combined with transforaminal approaches if the ventricular hydrocephalus is not much expressed, foramen of Monro is not much enlarged to complete transforaminal proccedure as well as when the tumor spreads to the posterior compartment of the third ventricle. 4. The number of complications related to the frontal transcortical transventricular approach in our series is 14.8 %, and they had transient nature and relapsed within a month postop; no postoperative mortality.

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Section: Resultsmentioning

confidence: 99%

Peculiarities of the third ventricle surgery in endoscopic frontal transcortical approach

et al. 2019

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“…To enter the lateral and third ventricle a variety of approaches have been described including the frontaltranscortical, the anterior/posterior interhemispheric-transcallosal and the contralateral interhemispherictransfalcine-transprecuneal approach (17)(18)(19)(20)(21)(22). They allow excellent visualization of important anatomical structures like the thalamostriatal, anterior-septal and caudate veins, foramen of Monro and choroid plexus (23).…”

Section: Surgical Approach 411 Approaches To the Lateral And Third mentioning

confidence: 99%

“…The transvermian approach has been performed frequently in history, but data showed high rates of cerebellar mutism and disequilibrium (15,16). To enter the lateral and/or third ventricle a variety of approaches have been described including the frontal-transcortical, the anterior/posterior interhemispheric-transcallosal and the contralateral interhemispheric-transfalcine-transprecuneal approach (17)(18)(19)(20)(21)(22).…”

Section: Introductionmentioning

confidence: 99%

Intraventricular neuroepithelial tumors: Surgical outcome, technical considerations and review of literature

Aftahy

Barz

Krauss

et al. 2020

Preprint

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Background Intraventricular neuroepithelial tumors (IVT) are rare lesions and comprise different pathological entities such as ependymomas, subependymomas and central neurocytomas. The treatment of choice is neurosurgical resection, which can be challenging due to their intraventricular location. Different surgical approaches to the ventricles are described. Here we describe a large series of IVTs, its postoperative outcome at a single tertiary center and discuss suitable surgical approaches. Methods We performed a retrospective chart review at a single tertiary neurosurgical center between 03/2009-05/2019. We included patients that underwent resection of an IVT emphasizing on surgical approach, extent of resection, clinical outcome and postoperative complications. Results 45 IVTs were resected from 03/2009 to 05/2019, 13 ependymomas, 21 subependymomas, 10 central neurocytomas and one glioependymal cyst. Median age was 52,5 years with 55.6% (22) male and 44.4% (20) female patients. Gross total resection was achieved in 93.3% (42/45). 84.6% (11/13) of ependymomas, 100% (12/21) of subependymomas, 90% (9/10) of central neurocytomas and one glioependymal cyst were completely removed. Postoperative rate of new neurological deficits was 26.6% (12/45). Postoperative new permanent cranial nerve deficits occurred in one case with 4th ventricle subependymoma and one in 4th ventricle ependymoma. Postoperative KPSS was 90% (IR 80–100). 31.1% of the patients improved in KPSS, 48.9% remained unchanged and 20% declined. Postoperative adverse events rate was 20.0%. Surgery-related mortality was 2.2%. The rate of shunt/cisternostomy-dependent hydrocephalus was 13.3% (6/45). 15.4% of resected ependymomas underwent adjuvant radiotherapy. Mean follow-up was 26,9 (± 30.1) months. Conclusion Our surgical findings emphasize satisfactory complete resection throughout all entities. Surgical treatment can remain feasible, if institutional experience is given. Satisfying long-term survival and cure is possible by complete removal. Gross total resection should always be performed under function-remaining aspects due to mostly benign or slow growing nature of IVTs. Further data is needed to evaluate standard of care and alternative therapy options in rare cases of tumor recurrence or in case of patient collective not suitable for operative resection.

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“…Extension of surgical excision is still an important predictor of outcome. Achieving a gross total resection of the tumor without significant complication requires a thorough understanding of available surgical approaches [15,17,[30][31][32]. For majority of those patients, short-course radiotherapy with concurrent and adjuvant TMZ will bring a benefit, while gain from bevacizumab is limited [13].…”

Section: Is There Hopementioning

confidence: 99%

Introductory Chapter: Glioma - Merciless Medical Diagnosis

Omerhodžić¹

2019

Glioma - Contemporary Diagnostic and Therapeutic Approaches

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Microsurgical resection of tumors of the lateral and third ventricles: operative corridors for difficult-to-reach lesions

Cited by 71 publications

References 53 publications

Peculiarities of the third ventricle surgery in endoscopic frontal transcortical approach

Peculiarities of the third ventricle surgery in endoscopic frontal transcortical approach

Intraventricular neuroepithelial tumors: Surgical outcome, technical considerations and review of literature

Introductory Chapter: Glioma - Merciless Medical Diagnosis

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