Your browser doesn't support javascript.
loading
Telovelar versus transvermian approach to tumors of the fourth ventricle and their impact on postoperative neurological complications: A multicenter study.
Pettersson, Samuel D; Jabbar, Redwan; Poplawska, Miroslawa; Och, Aleksander; Orrego-Gonzalez, Eduardo; Klepinowski, Tomasz; Krakowiak, Michal; Sagan, Leszek; Radek, Maciej; Zakrzewski, Krzysztof; Nowoslawska, Emilia; Kwiecien, Katarzyna; Skrzypkowska, Paulina; Szmuda, Tomasz; Miekisiak, Grzegorz; Vega, Rafael A.
Afiliação
  • Pettersson SD; Department of Neurosurgery, Medical University of Gdansk, Gdansk, Poland.
  • Jabbar R; Department of Neurosurgery, Medical University of Lodz, Lodz, Poland.
  • Poplawska M; Institute of Medicine, Opole University, Opole, Poland.
  • Och A; Department of Neurosurgery, Medical University of Gdansk, Gdansk, Poland.
  • Orrego-Gonzalez E; Division of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, United States.
  • Klepinowski T; Department of Neurosurgery, Pomeranian Medical University, Szczecin.
  • Krakowiak M; Department of Neurosurgery, Medical University of Gdansk, Gdansk, Poland.
  • Sagan L; Department of Neurosurgery, Pomeranian Medical University, Szczecin.
  • Radek M; Department of Neurosurgery, Medical University of Lodz, Lodz, Poland.
  • Zakrzewski K; Department of Neurosurgery, Polish Mother Memorial Research Institute, Poland.
  • Nowoslawska E; Department of Neurosurgery, Polish Mother Memorial Research Institute, Poland.
  • Kwiecien K; Department of Neurosurgery and Neuro-oncology, Medical University of Lodz, Lodz, Poland.
  • Skrzypkowska P; Department of Neurosurgery, Medical University of Gdansk, Gdansk, Poland.
  • Szmuda T; Department of Neurosurgery, Medical University of Gdansk, Gdansk, Poland.
  • Miekisiak G; Institute of Medicine, Opole University, Opole, Poland.
  • Vega RA; Division of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, United States.
Surg Neurol Int ; 14: 124, 2023.
Article em En | MEDLINE | ID: mdl-37151430
Background: Tumors of the fourth ventricle are exceedingly rare; however, such lesions are formidable due to the severe postoperative neurological complications (pNCs) which often occur. The adoption of the telovelar approach over the transvermian was created to supposedly mitigate the pNCs; however, there is a lack of sufficient data supporting this theory. Methods: Records from six hospitals were reviewed for patients surgically treated for a single tumor within the 4th ventricle from 2016 to 2022. The pNCs which had 10 or more occurrences among the patients were individually assessed as the dependent variable in a binary logistic regression model against covariates which included the surgical approach. Results: This study of 67 patients confirms no significant differences in risk for pNCs between the transvermian and telovelar approach. Rather, multivariate analysis identified neurophysiological monitoring (IONM) as a protective factor for postoperative speech and swallowing defects (odds ratio [OR]: 0.076, 95% confidence interval [CI] 0.011-0.525). Furthermore, intraoperative external ventricular drainage (EVD) was a protective factor for postoperative gait and focal motor defects (OR: 0.075, 95% CI 0.009-0.648) and for postoperative hydrocephalus (OR: 0.020, 95% CI 0.002-0.233). A univariate meta-analysis pooling the present study's patients and an additional 304 patients from the three additional studies in the literature confirms no significant differences in risk between the transvermian and telovelar approach for pNCs. Conclusion: Intraoperative adjuncts including IONM and EVD may play a significant role in the postoperative outcome. Despite the present study's sample size being a major limitation, the findings may provide great value to neurosurgeons given the scarcity of the current literature.
Palavras-chave

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Clinical_trials / Prognostic_studies Idioma: En Revista: Surg Neurol Int Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Clinical_trials / Prognostic_studies Idioma: En Revista: Surg Neurol Int Ano de publicação: 2023 Tipo de documento: Article