%0 Journal Article
%T Neuroendoscopic Resection of Intraventricular Tumors: A Systematic Outcomes Analysis
%A Sean M. Barber
%A Leonardo Rangel-Castilla
%A David Baskin
%J Minimally Invasive Surgery
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/898753
%X 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 systematic review of the literature to provide a better understanding of the virtues and limitations of endoscopic tumor resection. Materials and Methods. 40 articles describing 668 endoscopic tumor resections were selected from the Pubmed database and reviewed. Results. Complete or near-complete resection was achieved in 75.0% of the patients. 9.9% of resected tumors recurred during the follow-up period, and procedure-related complications occurred in 20.8% of the procedures. Tumor size ¡Ü 2cm ( ), the presence of a cystic tumor component ( ), and the use of navigation or stereotactic tools during the procedure ( ) were each independently associated with a greater likelihood of complete or near-complete tumor resection. Additionally, the complication rate was significantly higher for noncystic masses than for cystic ones ( ). Discussion. Neuroendoscopic outcomes for intraventricular tumor resection are significantly better when performed on small, cystic tumors and when neural navigation or stereotaxy is used. Conclusion. Neuroendoscopic resection appears to be a safe and reliable treatment option for patients with intraventricular tumors of a particular morphology. 1. Introduction Intraventricular tumors present a unique challenge for the neurosurgeon. Their deep location and proximity to eloquent neurovascular anatomy complicate surgical approach and resection [1]. Microsurgery remains the gold standard for the treatment of intraventricular tumors [1¨C4], but microsurgical approaches are not without limitations [5¨C12]. The desire for a less invasive but equally effective surgical approach to intraventricular pathology has directed the attention of many in the neurosurgical community towards neuroendoscopy. Neuroendoscopy was introduced in the early 1900s, adopted initially by Dandy [13] and others [14, 15] as a novel means of treating hydrocephalus [16], but the technique was overshadowed midcentury by the advent of the valved ventriculoperitoneal (VP) shunt [17, 18]. Years later, neuroendoscopy regained popularity due to improvements in optical technology and the introduction of the rigid and flexible neuroendoscopes [16, 19, 20]. Today, neuroendoscopic techniques have further evolved, and the spectrum of intracranial pathologies treatable by modern neuro-endoscopic means continues to
%U http://www.hindawi.com/journals/mis/2013/898753/