Endoscopic and Microscopic Transsphenoidal Surgery of Craniopharyngiomas: A Systematic Review of Surgical Outcomes Over Two Decades.
J Neurol Surg A Cent Eur Neurosurg
; 79(3): 247-256, 2018 May.
Article
in En
| MEDLINE
| ID: mdl-29195268
ABSTRACT
OBJECTIVE:
Few studies have compared transsphenoidal endoscopic (TE) and transsphenoidal microscopic (TM) techniques for the treatment of craniopharyngiomas.DESIGN:
We performed a systematic review of published series. The results were stratified in two time periods from 1995 to 2016.RESULTS:
A total of 48 articles and 1,186 patients met the inclusion criteria. Overall, 60% of endoscopic cases were supradiaphragmatic, and 76% of microsurgical cases were infradiaphragmatic. Mean tumor size was 3 cm and 2.4 cm in the TE and TM series, respectively (p = 0.008). Total resection rate was similar (66%) between TE and TM. Considering the surgical outcome for different tumor locations, total resection rate was slightly higher in the TE for supradiaphragmatic lesions (59% versus 42.5%; p = 0.26). Recurrence rate was higher in the endoscopic series (21.7% versus 12%). Mortality and the overall complication rates were similar (p = 0.84). However, hydrocephalus (7.6%) and cognitive dysfunction (15.8%) were more common in TE, and meningitis (6%) and endocrinologic complications were more common in the TM series. In the past 6 years, the rate of cerebrospinal fluid leak in TE was significantly lower (13%) and was comparable between TE and TM.CONCLUSION:
Both techniques appear comparable for infradiaphragmatic lesions; however, TE seems to yield better results for supradiaphragmatic tumors. In conclusion, more complex lesions with difficult locations can be effectively treated with endoscopic surgery.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pituitary Neoplasms
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Craniopharyngioma
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Endoscopy
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Microsurgery
Type of study:
Systematic_reviews
Limits:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Language:
En
Journal:
J Neurol Surg A Cent Eur Neurosurg
Year:
2018
Document type:
Article
Affiliation country: