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Published on: June 28, 2024
Endoscope-Assisted Transcranial Surgery for Petroclival Meningiomas: A Single-Centre Experience
Xiaoyu Ji1, Siyuan Yang1, Peng Zhou1
1Department of Neurosurgery, The First Affiliated Hospital of Soochow University, Suzhou, China.
Objective:
The surgical management of petroclival meningioma (PCM) remains a challenge in neurosurgery. This study compared the outcomes of endoscope-assisted microsurgery and conventional microscopic approaches to evaluate the safety and efficacy of endoscope-assisted transcranial techniques for PCM treatment.
Methods:
This retrospective case-control study was conducted at our hospital. Clinical data from January 2018 and June 2024 were retrospectively analyzed. The primary outcome was gross total resection (GTR) rate, and the secondary outcomes included patient status, tumor progression or recurrence. Propensity score matching (PSM) was used to account for group differences.
Results:
We enrolled 62 patients; 18 underwent endoscope-assisted transcranial surgery and 44 underwent transcranial microscopic surgery. The endoscope-assisted transcranial microsurgery group exhibited a higher GTR rate, shorter postoperative hospital stay, and lower tumor progression or recurrence rates than the transcranial microscopic surgery group (GTR: 83.3% vs. 52.3%, P = 0.046); postoperative hospital stay duration: 9.50 days [8.00, 13.75] vs. 13.00 days [10.00, 17.25], P = 0.023; and lower tumor progression or recurrence: 0 vs. 15.9%). After PSM, the endoscope-assisted surgery group had a better GTR rate, compared with the microsurgery group (odds ratio: 7.51 [1.37, 41.10], 95% confidence interval: 1.37-41.10, P = 0.021).
Conclusions:
PCM remains a surgical challenge. Endoscope-assisted microsurgery provides an increased GTR rate, offering excellent visualization and access to tumors. Therefore, it may be recommended as a first-line treatment for patients with PCM.
Insights
Endoscope-assisted microsurgery offers a higher gross total resection rate for petroclival meningioma (PCM) compared to conventional microscopic surgery. This advanced technique also leads to shorter hospital stays and reduced tumor recurrence, making it a promising first-line treatment option.
Area of Science:
- Neurosurgery
- Surgical Oncology
Background:
- Petroclival meningiomas (PCMs) present significant surgical challenges due to their complex anatomical location.
- Conventional microscopic approaches have limitations in achieving complete tumor resection and visualization.
Purpose of the Study:
- To compare the outcomes of endoscope-assisted microsurgery versus conventional microscopic surgery for petroclival meningioma.
- To evaluate the safety and efficacy of endoscope-assisted transcranial techniques in treating PCMs.
Main Methods:
- Retrospective case-control study analyzing clinical data from January 2018 to June 2024.
- Involved 62 patients: 18 with endoscope-assisted surgery and 44 with conventional microscopic surgery.
- Propensity score matching (PSM) was utilized to control for baseline differences between the groups.
Main Results:
- Endoscope-assisted microsurgery achieved a significantly higher gross total resection (GTR) rate (83.3% vs. 52.3%, P=0.046).
- Patients undergoing endoscope-assisted surgery experienced shorter postoperative hospital stays (9.50 days vs. 13.00 days, P=0.023).
- Tumor progression or recurrence was lower in the endoscope-assisted group (0% vs. 15.9%) and remained significantly better after PSM (OR 7.51, P=0.021).
Conclusions:
- Endoscope-assisted microsurgery enhances visualization and tumor access for petroclival meningiomas.
- This technique demonstrates superior outcomes, including higher GTR rates and reduced recurrence.
- Endoscope-assisted microsurgery is recommended as a potential first-line treatment for PCM.
