Concomitant, Single Burr Hole Endoscopic Third Ventriculostomy and Tumor Biopsy for Pineal Lesions: Feasibility, Safety, and Benefits

Leone, Augusto; Colamaria, Antonio; Fochi, Nicola Pio; Napoli, Veronica Di; Blagia, Maria; Sacco, Matteo Antonio; Winkler, Gerd; Spetzger, Uwe; Almerayed, Wessam; Carbone, Francesco

doi:10.1016/j.wneu.2023.01.082

Cited by 8 publications

(2 citation statements)

References 38 publications

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“…Furthermore, the possibility of concurrent CSF pathway reconstruction via ETV through the same approach is a significant advantage when considering tumor surgery in children. ETV has proven to be a valuable adjunctive procedure in cases where CSF diversion is required, reducing the need for additional surgeries such as ventriculoperitoneal (VP) shunting [ 17 , 35 – 37 ]. A subsequent minimization of potential complications associated with traditional CSF diversion procedures, such as infection, mechanical failure, and the need for revisions, may contribute to favorable long-term clinical outcomes.…”

Section: Discussionmentioning

confidence: 99%

The minimally invasive transventricular endoscopic approach to third ventricular lesions in pediatric patients—all-rounder with limitations?

Teping

Oertel

2023

Childs Nerv Syst

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Introduction The surgical management of third ventricular lesions poses unique challenges, requiring careful consideration of various approaches and techniques. This study focuses on the transventricular transforaminal endoscopic approach and aims to provide insights into its indications, limitations, technical nuances, and potential complications in pediatric patients. Methods A retrospective analysis was conducted using data from a 13-year period on pediatric patients who were subjected to transforaminal endoscopic surgery for third ventricular lesions. The study utilized a prospectively maintained internal database, extracting demographic data, preoperative assessment, surgical details, and postoperative follow-up information. The surgical technique is presented in detail, and exemplary case reports highlight relevant surgical considerations. Results Out of 578 endoscopic transforaminal procedures, 24 surgeries were performed on pediatric patients with third ventricular lesions. Performed procedures consisted of cyst resection (13 cases), solid tumor resection (4 cases), and tumor biopsies with CSF pathway restoration (7 cases). The mean age at the time of surgery was 7.6 years. Postoperatively, 14 patients showed transient nausea and vomiting (58.3%); 10 patients showed pneumocephalus on postoperative MRI (41.7%). No emergency postoperative re-interventions nor perioperative mortality were observed. Conclusion The endoscopic transventricular transforaminal approach is a safe approach for lesion resection, CSF pathway restoration, and tumor biopsy in pediatric patients with third ventricle lesions. The author’s results support the use of this minimally invasive technique as an alternative to more extensive approaches, particularly to the interforniceal interhemispheric approach. However, surgical success is highly dependent to the individual surgeon’s experience and moreover to a suitable indication setting. Careful preoperative planning and knowledge of the approaches’ pro and cons is mandatory for successful application of this approach.

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Section: Discussionmentioning

confidence: 99%

The minimally invasive transventricular endoscopic approach to third ventricular lesions in pediatric patients—all-rounder with limitations?

Teping

Oertel

2023

Childs Nerv Syst

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“…The advantages include therapeutic and diagnostic functions and reduced number of procedures for the patient. Most authors advocate for performing the biopsy after the ETV because of the possibility of visual obstruction due to bleeding associated with tumor biopsy (15,16,28).…”

Section: Intraventricular Endoscopymentioning

confidence: 99%

Review of surgical spproaches for posterior fossa tumors in pediatric population and illustrative cases

Moreira,

Bellas,

Pousa

et al. 2023

Arch Pediatr Neurosurg

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Introduction/Background: Posterior fossa tumors are common in the pediatric population, and various surgical approaches have been described to reach them based on their specific location. This paper aims to review the most common posterior fossa approaches in pediatric patients and present illustrative cases to provide insights into their successful application in specific clinical scenarios. Case report: Three cases are presented, each demonstrating a different approach and surgical outcome. Case 1 involved a telovelar approach for the resection of a medulloblastoma, resulting in complete removal without neurological deficits. Case 2 required a combination of telovelar and supracerebellar infratentorial approaches to achieve gross total resection of a pilocytic astrocytoma. In Case 3, an occipital transtentorial approach was utilized to access and completely resect an atypical teratoid rhabdoid tumor. Connclusion: The paper discusses the telovelar and transvermian approaches, the supracerebellar infratentorial approach, the transtentorial suboccipital approach, and intraventricular endoscopy as individual or combined approaches for posterior fossa tumors. The presented cases highlight the importance of tailoring the surgical approach to each patient and provide valuable insights for neurosurgeons managing similar clinical scenarios.

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Endoscopic and exoscopic surgery for brain tumors

Sasagawa,

Tanaka,

Kinoshita

et al. 2024

Int J Clin Oncol

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Concomitant, Single Burr Hole Endoscopic Third Ventriculostomy and Tumor Biopsy for Pineal Lesions: Feasibility, Safety, and Benefits

Cited by 8 publications

References 38 publications

The minimally invasive transventricular endoscopic approach to third ventricular lesions in pediatric patients—all-rounder with limitations?

The minimally invasive transventricular endoscopic approach to third ventricular lesions in pediatric patients—all-rounder with limitations?

Review of surgical spproaches for posterior fossa tumors in pediatric population and illustrative cases

Endoscopic and exoscopic surgery for brain tumors

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