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The effectiveness of neuroendoscopic interventions in children with brain tumours
D C Macarthur1, N Buxton, M Vloeberghs
1Department of Neurosurgery, University Hospital, Queen's Medical Centre, Nottingham NG7 2UH, UK. Donald.Macarthur@Nottingham.ac.uk
Insights
Neuroendoscopic interventions effectively manage hydrocephalus in pediatric brain tumor patients. These minimally invasive procedures offer diagnostic biopsies and tumor resections with a favorable safety profile.
Area of Science:
- Pediatric Neurosurgery
- Minimally Invasive Surgery
- Neuro-oncology
Background:
- Hydrocephalus is a common complication of pediatric brain tumors.
- Traditional treatments for hydrocephalus can be invasive.
- Neuroendoscopy offers a less invasive alternative.
Purpose of the Study:
- To evaluate the effectiveness of neuroendoscopic interventions for brain tumors and associated hydrocephalus in children.
- To assess the safety and outcomes of neuroendoscopic procedures in this patient population.
Main Methods:
- A retrospective review of 61 neuroendoscopic procedures in 53 children over 6 years.
- Patients ranged from 5 months to 18 years old.
- Analysis of outcomes for hydrocephalus management, tumor biopsy, and tumor resection.
Main Results:
- Neuroendoscopic third ventriculostomy (NTV) provided short-term hydrocephalus relief in 45/47 cases and long-term relief in 39/47.
- Neuroendoscopic biopsy yielded definitive diagnoses in 10/16 cases.
- Five tumors were resected with one unrelated postoperative death and minimal complications.
Conclusions:
- Neuroendoscopic techniques are effective for managing hydrocephalus in pediatric brain tumor patients.
- These methods allow for CSF sampling and tumor biopsy in select cases.
- Neuroendoscopy presents a safe and effective option for pediatric neuro-oncology care.
Object:
The purpose of this study was to review the efficacy of neuroendoscopic interventions in children with brain tumours and tumour-related hydrocephalus.
Methods:
In all, 61 consecutive neuroendoscopic operations carried out in 53 children with brain tumours over a 6-year period were reviewed. The patients ranged in age from 5 months to 18 years (median 9 years). Forty of 61 presentations were with a newly diagnosed tumour and hydrocephalus - the remainder predominantly had a known tumour and worsening hydrocephalus.
Conclusions:
Neuroendoscopic third ventriculostomy (NTV) successfully relieved hydrocephalus in the short term in 45 of 47 cases and in the longer term in 39 of 47 cases. Neuroendoscopic biopsy provided definitive tissue diagnosis in 10 of 16 cases and 5 tumours were resected. There was 1 postoperative death, which not directly related to the neuroendoscopy and few significant complications otherwise. Neuroendoscopic methods allow effective immediate and longer term control of hydrocephalus as well as the opportunity for CSF sampling and tumour biopsy in selected cases.
