Neuroendoscopic Resection of Intraventricular Tumors: A Systematic Outcomes Analysis

Abstract

Introduction. Though traditional microsurgical techniques are the gold standard for intraventricular tumor resection, the morbidity and invasiveness of microsurgical approaches to the ventricular system have galvanized interest in neuroendoscopic resection. We present a systematic review of the literature to provide a better understanding of the virtues and limitations of endoscopic tumor resection. Materials and Methods. 40 articles describing 668 endoscopic tumor resections were selected from the Pubmed database and reviewed. Results. Complete or near-complete resection was achieved in 75.0% of the patients. 9.9% of resected tumors recurred during the follow-up period, and procedure-related complications occurred in 20.8% of the procedures. Tumor size ≤ 2cm (P = 0.00146), the presence of a cystic tumor component (P < 0.0001), and the use of navigation or stereotactic tools during the procedure (P = 0.0003) were each independently associated with a greater likelihood of complete or near-complete tumor resection. Additionally, the complication rate was significantly higher for noncystic masses than for cystic ones (P < 0.0001). Discussion. Neuroendoscopic outcomes for intraventricular tumor resection are significantly better when performed on small, cystic tumors and when neural navigation or stereotaxy is used. Conclusion. Neuroendoscopic resection appears to be a safe and reliable treatment option for patients with intraventricular tumors of a particular morphology.

Initial experience with endoscopic ultrasonic aspirator in purely neuroendoscopic removal of intraventricular tumors

“…In a recent meta-analysis by Barber et al, 2 40 studies focusing on endoscopic resection of intraventricular tumors were reported. More than 650 cases were identified.…”

Conversion technique from neuroendoscopy to microsurgery in ventricular tumors: Technical note

“…[1451725] The low incidence, deep location, and narrowness of the surgical field make this kind of tumor a constant challenge to neurosurgeons. [425] There are two main options for open craniotomy microsurgical approach to the third ventricle and anterior lateral ventricle tumors, that is, the transcortical transventricular approach and the interhemispheric transcallosal approach. [371923] Which approach to adopt may depend on the location of the lesion within the ventricle, the goals of the operation, and the surgeon's experience.…”

“…[4101113] The endoscopic approach is broadly used in ventricular tumors for the treatment of hydrocephalus, tumor biopsy, and tumor resection. It is a technique that reduces the manipulation of normal brain tissue in deep seated lesions.…”

“…It is a technique that reduces the manipulation of normal brain tissue in deep seated lesions. [462122] There are some ideal tumor characteristics that facilitate resection such as lesion size smaller than 20–30 mm diameter, soft consistency, cystic aspect, hydrocephalus association, and low to moderate vascularization. [26] In some cases, conversion is necessary due to uncontrolled bleeding, solid and hardened tumor aspect, large base implantation size, as well as technical problems such as instrument malfunction.…”

“…[5] At present, endoscopic technique is broadly used for the treatment of tumor related hydrocephalus, ventricle tumor biopsy, and/or resection in a minimally invasive way, with minimal manipulation of normal brain tissue. [2461214212224] Despite established as an option for ventricular tumor resection in selected cases, the method is not exempt of complications and limitations. [81422] Greenlee et al .…”