• World Neurosurg · Aug 2022

    Combined Neuro-endoscopic Techniques in the Management of Pediatric Brain and Skull Base Tumors: A Single Institutional Case Series.

    • Elena Greco, Gustavo M Cortez, Andre Monteiro, Manuel Granja, Kelsey Garrity, Sabrina Han, Alexandra Beier, Nathan Ranalli, Ricardo A Hanel, and Philipp R Aldana.
    • Lyerly Neurosurgery, Baptist Neurological Institute, Jacksonville, Florida, USA; San Paolo Medical School, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy.
    • World Neurosurg. 2022 Aug 1; 164: e134-e142.

    BackgroundCentral nervous system tumors encompass the leading cause of cancer-related death in the pediatric population. Neuroendoscopic techniques have been optimized over the years, becoming an important tool for the management of brain tumors. Our study aims to review the indications for neuroendoscopic procedures and the feasibility of combined interventions.MethodsThis is a single-center, self-adjudicated, retrospective experience. Inclusion criteria consisted of pediatric patients (≤18 years old) who underwent management of brain tumor or related diseases with the employment of neuroendoscopy.ResultsA total of 47 patients undergoing 51 procedures met inclusion criteria. The mean age was 9.8 ± 4.6 years, and the majority were female (55.3%). Common indications for endoscopic intervention were hydrocephalus management (n = 24; 16 endoscopic third ventriculostomies and 9 septostomies), tumor biopsy (n = 19), cyst fenestration (n = 16), and tumor resection (n = 9). In one third of the cases, combined interventions occurred during a single operative session. Hydrocephalus was successfully managed in 74.4% of cases; tumor biopsy confirmed the diagnosis in 95.8% of cases, and gross total resection was achieved in 88.9% of cases. Cyst fenestration required reintervention in 3 cases: one case associated with initial cyst enlargement and 2 cases with the development of new tumor cysts separated from the originally fenestrated cyst. The overall complication rate was 6.3%, with only one major safety event, which was successfully managed.ConclusionsNeuroendoscopy is an important minimally invasive tool for diagnosing and treating pediatric patients with brain tumors, permitting to address multiple problems in a single surgery.Copyright © 2022 Elsevier Inc. All rights reserved.

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