Neuroendoscopic surgery in children: an analysis of 200 consecutive procedures

Furlanetti, Luciano; Santos, Marcelo Volpon; Oliveira, Ricardo Santos de

doi:10.1590/s0004-282x2013000300007

Cited by 8 publications

(10 citation statements)

References 40 publications

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“…7,10 In agreement with our study, a detailed consecutive analysis of 200 neuroendoscopic procedures performed in 177 pediatric patients reported an overall complication rate of 11% with no difference in complication rates between separate age groups (0-6 months, 6-12 months, and ≥ 1 year). 10 Hence, we conclude that intraventricular surgery is safe among the youngest age groups, including those younger than 1 year of age.…”

Section: Discussionsupporting

confidence: 89%

“…Although there are several large series documenting the complication rates of ETV, 3,4,7,8,21 few publications have reviewed pediatric endoscopic procedures as a whole. 10 Despite this, our complication rates are comparable to those in previously published studies. 7,10 In agreement with our study, a detailed consecutive analysis of 200 neuroendoscopic procedures performed in 177 pediatric patients reported an overall complication rate of 11% with no difference in complication rates between separate age groups (0-6 months, 6-12 months, and ≥ 1 year).…”

Section: Discussionsupporting

confidence: 86%

“…Our results are comparable to those in the published literature, with Elgamal et al and Furlanetti et al reporting overall CSF infection rates of 2.0% and 4.0%, respectively. 7,10 Importantly, there was no significant difference in CSF infection rates between age groups (p = 0.912) ( Fig. 1B).…”

Section: Discussionmentioning

confidence: 87%

“…Seven neuroendoscopic procedures were performed in infants younger than 1 month. As hydrocephalus is probably the most common pathology requiring neurosurgical intervention in pediatric patients, 6,10 it is not surprising that the majority of patients within the current study underwent ETV (n = 159) for the management of CSF-related disorders (defined at GOSH as hydrocephalus or nontumor cysts, e.g., arachnoid or porencephalic), closely followed by the biopsy and/or resection of intracranial tumors (n = 102) ( Table 2). As expected, primary diagnosis varied according to age, with younger infants more likely to require intraventricular surgery for the management of CSFrelated disorders, whereas for older pediatric patients, the indication for neuroendoscopy was more commonly tumor related (Table 2).…”

Section: Discussionmentioning

confidence: 99%

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Neuroendoscopic surgery in children: does age at intervention influence safety and efficacy? A single-center experience

Bowes¹,

King-Robson²,

Dawes³

et al. 2017

Journal of Neurosurgery: Pediatrics

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OBJECTIVEThe aim of this study was to review the safety of pediatric intraventricular endoscopy across separate age groups and to determine whether intraventricular endoscopy is associated with an increased risk of complications or reduced efficacy in infants younger than 1 year.METHODSIn this retrospective cohort study, 286 pediatric patients younger than 17 years underwent intraventricular endoscopy at Great Ormond Street Hospital between December 2005 and December 2014. The primary diagnosis, procedure, and complications were recorded.RESULTSNeuroendoscopic surgery was performed in 286 pediatric patients (51 neonates 0–6 months [Group 1]; 37 infants 6–12 months [Group 2]; 75 patients 1–5 years [Group 3]; 54 patients 5–10 years [Group 4]; and 69 patients ≥ 10 years [Group 5]; male/female ratio 173:113). The most common procedures included endoscopic third ventriculostomy (ETV) in 159 patients and endoscopic fenestration of intracranial cysts in 64 patients. A total of 348 consecutive neuroendoscopic procedures were undertaken. Nine different complications were identified, of which postoperative seizures (1.7%), CSF leak (3.1%), CSF infection (2.4%), and intracranial hemorrhage (1.7%) were the most common. Specifically, no significant difference in complication rate (11.9%) or infection rate (2.4%) was observed among age groups (p = 0.40 and p = 0.91, respectively). In addition, there were no perioperative deaths; 30-day mortality was 1.1%. After neuroendoscopy for CSF diversion (n = 227), a significantly higher rate of shunt insertion was observed in the youngest group (Group 1, 63.0%) when compared with older groups (Group 2, 46.4%; Group 3, 26.3%; Group 4, 38.6%; and Group 5, 30.8%; p = 0.03). Similarly, for patients who underwent ETV as their initial neuroendoscopic procedure or in combination with additional surgical interventions (n = 171), a significantly higher rate of shunt insertion was also observed within young infants (Group 1, 67.9%; Group 2, 47.6%; Group 3, 19.6%; Group 4, 27.3%; and Group 5, 23.3%; p = 0.003).CONCLUSIONSIntraventricular endoscopy is a safe neurosurgical intervention in pediatric patients of all ages, although it might be associated with increased shunt rates after endoscopic surgery, specifically ETV, in younger infants.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Neuroendoscopic surgery in children: does age at intervention influence safety and efficacy? A single-center experience

Bowes¹,

King-Robson²,

Dawes³

et al. 2017

Journal of Neurosurgery: Pediatrics

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“…ETV has replaced external ventricular drainage (EVD) and shunting in the management of tumor obstructive hydrocephalus in most cases [5]- [10]. ETV performed before tumor removal diminishes occurrence of postoperative hydrocephalus after resection of posterior fossa tumors [6].…”

Section: Role Of Etv For Tumor Hydrocephalusmentioning

confidence: 99%

Tumor Obstructive Hydrocephalus Treated with Endoscopic Third Ventriculostomy in Cameroon

Ndoumbe¹,

Motah²,

Takongmo³

2015

OJMN

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The goal of this work was to report on a series of preoperative endoscopic third ventriculostomy (ETV) performed for obstructive hydrocephalus due to posterior fossa tumors. Eight patients underwent preoperative ETV prior to tumor biopsy or removal for obstructive hydrocephalus related to posterior fossa tumors. All patients underwent surgery in two steps; ETV followed a week later by tumor resection. Clinical, radiological and outcome data were retrospectively reviewed. Eight patients (6 males, 2 females) aged between 8 and 45 years (mean age 24.62 years) suffering from obstructive hydrocephalus due to posterior fossa tumors had ETV prior to tumor removal or biopsy. Five patients were adults while 3 were under 18 years. All patients complained of headaches, seven presented with symptoms of raised intracranial pressure or visual disturbances and four had vomiting or cerebellar disturbance. Computed tomography scan was done in all patients and magnetic resonance imaging in five. Complete tumor removal was achieved in 4 cases and partial removal or biopsy in the remaining 4. ETV was successful in 7 (87.50%) cases but failed in one. Two patients experienced intraoperative transitory bradycardia. Two postoperative complications occurred (one meningitis and one CSF leak). No death related to procedures occurred. The histological diagnosis were as follows: ependymoma (3), medulloblastoma (3), astrocytoma grade II (1) and pineoblastoma (1). Hospital stay ranged from 9 to 21 days (mean, 12.71 days). Follow up range was 4 months to 78.4 months (0.33 to 6.53 years; mean, 46.11 months (3.84 years); median, 41.2 months (3.43 years).

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