Increasing the Implication of Endoscopy to a Wide Spectrum of Intraventricular Lesions: A Review of Our Experience

Amir Aziz, Khurram Ishaque

Abstract


Introduction: Though traditional microsurgical techniques are the gold standard for intraventricular tumor resection, the morbidity and invasiveness of microsurgical approaches to the ventricular system have galvanized interest in neuroendoscopic resection. We present a case series to share our experience with endoscopic management of intraventricular lesion.
Materials and Methods: 17 patients, both male and female, from 5 to 50 years of age were endoscopically operated during 1.5 years. Intraventricular lesions < 4cm, mildly vascular and soft in consistency were included. The average operative time was 90 minutes and the average hospital stay was 4 ± 1.5 days. Follow up was done at 2 weeks, 6weeks and at 6 months.
Results: Out of 12 males and 5 females there were 6 colloid cysts, 3 supra sellar arachnoid cysts, 5 intraventri-cular tumors and 3 pineal tumors. Complete resection of lesion was achieved in 4 out of 6 patients with colloid cyst (66.6%). Size of supra sellar arachnoid cyst reduced along with improvement of hydrocephalus in all 3 patients (100%) Positive tumor biopsy was possible in 100% of cases. Adjuvant endoscopic third ventriculostomy was performed in 9 (52.9%). Septostomy was done in 1 (5.9%). Post op Ventriculoperitoneal shunt was required in 4 (23.5%) cases. There was no peri or post operative mortality.
Conclusion: With proper patient selection endoscopic surgery can yield results at par with microsurgery with added benefits of minimum patient discomfort, shorter hospital stay and improved cosmetic results.
Key word: Intraventricular tumor, colloid cyst, arachnoid cyst, pineal tumor, ventriculostomy, septostomy.

Full Text:

PDF

References


Barber S, Rangel – Castilla L, Baskin D. Neuroendo-

scopic Resection of Intraventricular Tumors: A Syste-matic Outcomes Analysis. Minimally Invasive Surgery, 2013; 2013: 1-12.

Ahmad F, Sandberg D. Endoscopic Management of Intraventricular Brain Tumors in Pediatric Patients: A Review of Indications, Techniques, and Outcomes. Jou-rnal of Child Neurology, 2010; 25 (3): 359-367.

Yamini B, Refai D, Rubin C, Frim D. Initial endoscopic management of pineal region tumors and associated hy-drocephalus: clinical series and literature review. Jour-nal of Neurosurgery: Pediatrics, 2004; 100 (5): 437-441.

Pineal region tumors: an optimal approach for simulta-neous endoscopic third ventriculostomy and biopsy. Neurosurg Focus [Internet]. 2011 [cited 28 July 2016]. Available from:

http://www.ncbi.nlm.nih.gov/pubmed/21456930

El-Ghandour N. Endoscopic treatment of suprasellar arachnoid cysts in children. Journal of Neurosurgery: Pediatrics, 2011; 8 (1): 6-14.

Gangemi M, Colella G, Magro F, Maiuri F. Suprasellar arachnoid cysts: endoscopy versus microsurgical cyst excision and shunting. British Journal of Neurosurgery, 2007; 21 (3): 276-280.

Yaşargil M, Abdulrauf S. Surgery of Intraventricular Tumors. Neurosurgery, 2008; 62 (Supplement 3): SHC-1029-SHC1041.

Goel A. Can the Hype of “Endoscope” Become a Rea-lity for Colloid Cyst Surgery? World Neurosurgery, 2013; 80 (5): 500-501.

Souweidane M, Luther N. Endoscopic resection of solid intraventricular brain tumors. Journal of Neurosurgery, 2006; 105 (2): 271-278.

Sampath R, Vannemreddy P, Nanda A. Microsurgical Excision of Colloid Cyst with Favorable Cognitive Out-comes and Short Operative Time and Hospital Stay. Neurosurgery, 2010; 66 (2): 368-375.

Teo CNakaji P. Neuro-oncologic applications of endo-scopy. Neurosurgery Clinics of North America, 2004; 15 (1): 89-103.

Schroeder H, Oertel J, Gaab M. Incidence of complicat-ions in neuroendoscopic surgery. Childs Nerv Syst. 2004; 20 (11-12): 878-883.

Boogaarts H, Decq P, Grotenhuis J, Le Guérinel C, Nseir R, Jarraya B et al. Long-term Results of the Neu-roendoscopic Management of Colloid Cysts of the Thi-rd Ventricle: A Series of 90 Cases. Neurosurgery, 2011; 68 (1): 179-187.

Peretta P, Ragazzi P, Galarza M, Genitori L, Giordano F, Mussa F et al. Complications and pitfalls of neuro-endoscopic surgery in children. Journal of Neurosur-gery: Pediatrics, 2006; 105 (3): 187-193.

Depreitere B, Dasi N, Rutka J, Dirks P, Drake J. Endo-scopic biopsy for intraventricular tumors in children. Journal of Neurosurgery: Pediatrics, 2007; 106(5): 340-346.


Refbacks

  • There are currently no refbacks.
';