Systematic review of pineal cysts surgery in pediatric patients.
Childs Nerv Syst
; 36(12): 2927-2938, 2020 12.
Article
in En
| MEDLINE
| ID: mdl-32691194
ABSTRACT
INTRODUCTION:
We present a consecutive case series and a systematic review of surgically treated pediatric PCs. We hypothesized that the symptomatic PC is a progressive disease with hydrocephalus at its last stage. We also propose that PC microsurgery is associated with better postoperative outcomes compared to other treatments.METHODS:
The systematic review was conducted in PubMed and Scopus. No clinical study on pediatric PC patients was available. We performed a comprehensive evaluation of the available individual patient data of 43 (22 case reports and 21 observational series) articles.RESULTS:
The review included 109 patients (72% females). Ten-year-old or younger patients harbored smaller PC sizes compared to older patients (p < 0.01). The pediatric PCs operated on appeared to represent a progressive disease, which started with unspecific symptoms with a mean cyst diameter of 14.5 mm, and progressed to visual impairment with a mean cyst diameter of 17.8 mm, and hydrocephalus with a mean cyst diameter of 23.5 mm in the final stages of disease (p < 0.001). Additionally, 96% of patients saw an improvement in their symptoms or became asymptomatic after surgery. PC microsurgery linked with superior gross total resection compared to endoscopic and stereotactic procedures (p < 0.001).CONCLUSIONS:
Surgically treated pediatric PCs appear to behave as a progressive disease, which starts with cyst diameters of approximately 15 mm and develops with acute or progressive hydrocephalus at the final stage. PC microneurosurgery appears to be associated with a more complete surgical resection compared to other procedures.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pineal Gland
/
Brain Neoplasms
/
Central Nervous System Cysts
/
Cysts
Type of study:
Systematic_reviews
Limits:
Child
/
Female
/
Humans
/
Male
Language:
En
Journal:
Childs Nerv Syst
Journal subject:
NEUROLOGIA
/
PEDIATRIA
Year:
2020
Document type:
Article
Affiliation country:
Finland