Retractorless surgery for third ventricle tumor resection through the transcallosal approach

Area of Science:

• Neurosurgery
• Oncology
• Neurology

Background:

• Resection of third ventricle tumors via the transcallosal-interforniceal approach is challenging.
• Retraction injury to deep brain structures and veins can cause significant postoperative deficits.

Purpose of the Study:

• To investigate the feasibility and value of a retractorless surgical technique for third ventricle tumor resection.
• To evaluate the impact of avoiding retraction on postoperative outcomes and brain edema.

Main Methods:

• A cohort of 31 patients with third ventricle tumors underwent surgery using a transcallosal-interforniceal approach with a straight incision.
• Self-retaining retractors were avoided; corpus callosum openings were sealed with fibrin glue.
• Tumor resection extent, postoperative neurological deficits, complications, and brain edema (T2 imaging) were analyzed.

Main Results:

• Eighty-one percent (25/31) of patients achieved total or gross total tumor resection.
• Postoperative neurological deficits occurred in only 12.9% (4/31) of patients, with good recovery from mutism.
• No significant retraction injuries were observed on T2 imaging, and complications like subdural hygroma were absent.

Conclusions:

• Retractorless surgery provides adequate exposure for third ventricle tumor resection.
• This technique is feasible and can reduce postoperative neurological deficits and complications by preventing retraction injury.