• Ye Gu, Quan Zhou, Wei Zhu, Qi Wu, Tao Xie, Silin Wu, Fan Hu, Yong Yu, Chongjing Sun, Chen Li, Bo Zhang, Liping Zhan, and Xiaobiao Zhang.
• Department of Neurosurgery, Zhongshan Hospital Affiliated to Fudan University, Shanghai, China; Shanghai Key Laboratory of Medical Image Computing and Computer Assisted Intervention, Shanghai Medical College, Fudan University, Shanghai, China.
• World Neurosurg. 2019 Aug 1; 128: e334-e339.

BackgroundThe cerebellomesencephalic vein (CMV) was frequently sacrificed in surgery approached via the supracerebellar infratentorial (SCIT) route for resecting pineal region tumors, which resulted in potential risk of neurologic deficit. Preserving the CMV in the SCIT approach could enhance the safety and effectiveness of this natural corridor surgery. The aim of this article was to identify the probability and safety of preserving the CMV through the application of neuroendoscopy in the SCIT approach.MethodsClinical data of patients who underwent pineal region tumor resection through a purely endoscopic SCIT approach were retrospectively analyzed, focusing on surgical techniques and clinical outcomes.ResultsThe study included 8 patients with pineal region tumors. The CMV was preserved intact in all patients. Total tumor removal was achieved in 7 of 8 patients. In 1 patient with 2 tumors in the pineal region and roof of the third ventricle, the tumor in the pineal region was resected completely, followed by subsequent chemotherapy combined with radiotherapy, after which the other tumor disappeared totally. All patients recovered normally with uneventful postoperative outcomes.ConclusionsThe advantage of close observation and panoramic view provided by neuroendoscopy combined with meticulous manipulation improved the ability to preserve the CMV in resecting pineal region tumors via the SCIT approach. The neuroendoscopic technique enhances the safety and efficacy of the SCIT approach.Copyright © 2019 Elsevier Inc. All rights reserved.

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