1. Neuroendoscopic biopsy and the treatment of tumor-associated hydrocephalus of the ventricular and paraventricular region in pediatric patients: a nationwide study in Japan.
- Author
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Miwa T, Hayashi N, Endo S, and Ohira T
- Subjects
- Adolescent, Biopsy adverse effects, Cerebral Ventricle Neoplasms surgery, Cerebrospinal Fluid Shunts, Child, Child, Preschool, Female, Humans, Hydrocephalus surgery, Infant, Infant, Newborn, Intraoperative Complications epidemiology, Intraoperative Complications therapy, Japan, Male, Neuroendoscopy adverse effects, Neurosurgical Procedures methods, Postoperative Complications epidemiology, Postoperative Complications therapy, Retrospective Studies, Treatment Outcome, Ventriculoperitoneal Shunt, Ventriculostomy methods, Biopsy methods, Cerebral Ventricle Neoplasms complications, Cerebral Ventricle Neoplasms diagnosis, Hydrocephalus diagnosis, Hydrocephalus etiology, Neuroendoscopy methods
- Abstract
A neuroendoscopic biopsy is a minimally invasive and useful procedure for the diagnosis and initial management of tumor-associated hydrocephalus. We describe the nationwide investigation of the current status of neuroendoscopic biopsy for intra- and paraventricular tumors in children, as well as the treatment of tumor-associated hydrocephalus in pediatric patients. The main items examined included the patient's age and sex, location of the tumor, pathological diagnosis, complications, treatment and efficacy of treatment of the tumor-associated hydrocephalus, and the dissemination during the postoperative course. Two hundred twenty-one pediatric patients (mean 8.6 years) from 67 institutions were registered. Endoscopic tumor biopsies were performed in 206 patients (93.2 %), and a histopathological diagnosis could be performed in 195 of these 206 patients (94.7 %). The most frequently histopathologically diagnosed tumor was a germ cell tumor (41.5 %), followed by astrocytic tumors (24.1 %) and cystic lesions (15.9 %). Associated hydrocephalus was observed in 177 patients (80.1 %), 101 of whom underwent endoscopic third ventriculostomy (ETV). The efficacy rate of the ETV in the perioperative period was 99.0 %, and the long-term response rate was 90.1 %. Perioperative complications other than fever were found in 24 patients (10.9 %). In the statistical analysis, pediatric long-term response rate to ETV (p = 0.025) showed significantly more favorable results for pediatric than adult patients (p < 0.05). Neuroendoscopic procedures involving pediatric intra- and paraventricular tumors were considered to be very useful, with a low incidence of complication, and were associated with higher safety.
- Published
- 2015
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