2017
DOI: 10.1007/s00701-017-3390-y
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The endoscopic endonasal approach is not superior to the microscopic transcranial approach for anterior skull base meningiomas—a meta-analysis

Abstract: ObjectIn the past decade, the endonasal transsphenoidal approach (eTSA) has become an alternative to the microsurgical transcranial approach (mTCA) for tuberculum sellae meningiomas (TSMs) and olfactory groove meningiomas (OGMs). The aim of this meta-analysis was to evaluate which approach offered the best surgical outcomes.MethodsA systematic review of the literature from 2004 and meta-analysis were conducted in accordance with the PRISMA guidelines. Pooled incidence was calculated for gross total resection (… Show more

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Cited by 101 publications
(111 citation statements)
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References 80 publications
(290 reference statements)
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“…Two prior systematic reviews focused on comparing outcomes between EEA and TCA for suprasellar meningiomas also demonstrated similar findings to our study . These prior reviews have reported rates of GTR ranging from 71.8% to 88% in the EEA group relative to rates of 73.1% to 87% in the TCA group, with no statistically significant difference noted between groups.…”
Section: Intradural Tumorssupporting
confidence: 88%
“…Two prior systematic reviews focused on comparing outcomes between EEA and TCA for suprasellar meningiomas also demonstrated similar findings to our study . These prior reviews have reported rates of GTR ranging from 71.8% to 88% in the EEA group relative to rates of 73.1% to 87% in the TCA group, with no statistically significant difference noted between groups.…”
Section: Intradural Tumorssupporting
confidence: 88%
“…As result of the evolution of endoscopic surgery for pituitary adenomas, these meningiomas have been increasingly excised using an endonasal endoscopic approach, however a meta-analysis by Ivo et al [17] indicates that the endoscopic transsphenoidal approach has not been shown to be superior to the microscopic surgery for Tuberculum sellae meningiomas. Moreover, it was associated a higher rate of vascular injury and more CSFleakthan microscopic approach.…”
Section: Surgical Techniquementioning
confidence: 99%
“…The role of endoscopic endonasal approach (EEA) in anterior skull base meningioma surgery has been widely debated in current literature. [1][2][3][4][5][6][7][8][9] Most of these tumors are located intradurally; therefore, their removal through a ventral route requires an osteodural opening with the risk of postoperative cerebrospinal fluid (CSF) leak. [1][2][3][4][5][6][7][8][9] This could suggest that such approach might seem "unnatural" because it does not follow natural surgical corridors and increases the risk of complications; however, many papers have considered that it could give many advantages both for surgeons and for patients.…”
Section: Introductionmentioning
confidence: 99%
“…[1][2][3][4][5][6][7][8][9] Most of these tumors are located intradurally; therefore, their removal through a ventral route requires an osteodural opening with the risk of postoperative cerebrospinal fluid (CSF) leak. [1][2][3][4][5][6][7][8][9] This could suggest that such approach might seem "unnatural" because it does not follow natural surgical corridors and increases the risk of complications; however, many papers have considered that it could give many advantages both for surgeons and for patients. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] Indeed, it adopts a completely extracranial route, which avoids any brain retraction, nerves or arteries crossing and manipulation, it allows an early devascularization, and it gives the possibility to remove the tumor, adopting the arachnoid as cleavage plane, and therefore, reducing the risk of damage by perforating vessels and optochiasmatic feeders.…”
Section: Introductionmentioning
confidence: 99%
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