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Introduction
Endoscopic third ventriculostomy (ETV) for obstructive hydrocephalus and endoscopic biopsy (EB) for intra- and paraventricular tumors are recognized as standard therapies because of their minimal invasiveness. Although EB-associated hemorrhagic risk has been well documented, reports on the ETV-associated hemorrhagic risk are only few. Therefore, we conducted this retrospective study to review the incidence of hemorrhage due to EB and/or ETV in a single institution.
Material and Methods
We retrospectively reviewed data, including patient characteristics, procedure, pathological findings, and complications, including hemorrhage, of 100 patients with intra- and paraventricular tumors who underwent EB and/or ETV at our institution from 2000 to 2020.
Results
EB and ETV combined surgery (combined group), EB-alone surgery (EB-alone group), and ETV-alone surgery (ETV-alone group) were performed in 44 (44%), 24 (24%), and 32 (32%) patients, respectively, and all procedures were successful. The rates of definitive and suggestive diagnoses in EB were 76.5% and 23.5%, respectively. Adverse events were observed in six patients. An acute obstruction of the ETV stoma and a transient double vision were observed in the combined group. Two transient aqueductal stenosis/obstructions were recognized in the EB-alone group. Hemorrhage was observed in two patients in the ETV-alone group; these patients developed intratumoral hemorrhage despite ETV-alone surgery. Subsequently, these two patients underwent tumor removal, and the histopathological diagnosis was atypical teratoid/rhabdoid tumor (AT/RT) in both.
Conclusions
For obstructive hydrocephalus with AT/RTs, physicians must be aware of the risk of postoperative intratumoral hemorrhage after performing ETV.
Trial registration number
E-2385 (2021/3/11)
Keywords
AT/RT, intratumoral hemorrhage, ETV, obstructive hydrocephalus
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A new preprint design is coming!
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This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research Article
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
View the published article at World Neurosurgery.
Version 1
Posted 22 Mar, 2021
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Neurosurgery
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at World Neurosurgery.
Introduction
Endoscopic third ventriculostomy (ETV) for obstructive hydrocephalus and endoscopic biopsy (EB) for intra- and paraventricular tumors are recognized as standard therapies because of their minimal invasiveness. Although EB-associated hemorrhagic risk has been well documented, reports on the ETV-associated hemorrhagic risk are only few. Therefore, we conducted this retrospective study to review the incidence of hemorrhage due to EB and/or ETV in a single institution.
Material and Methods
We retrospectively reviewed data, including patient characteristics, procedure, pathological findings, and complications, including hemorrhage, of 100 patients with intra- and paraventricular tumors who underwent EB and/or ETV at our institution from 2000 to 2020.
Results
EB and ETV combined surgery (combined group), EB-alone surgery (EB-alone group), and ETV-alone surgery (ETV-alone group) were performed in 44 (44%), 24 (24%), and 32 (32%) patients, respectively, and all procedures were successful. The rates of definitive and suggestive diagnoses in EB were 76.5% and 23.5%, respectively. Adverse events were observed in six patients. An acute obstruction of the ETV stoma and a transient double vision were observed in the combined group. Two transient aqueductal stenosis/obstructions were recognized in the EB-alone group. Hemorrhage was observed in two patients in the ETV-alone group; these patients developed intratumoral hemorrhage despite ETV-alone surgery. Subsequently, these two patients underwent tumor removal, and the histopathological diagnosis was atypical teratoid/rhabdoid tumor (AT/RT) in both.
Conclusions
For obstructive hydrocephalus with AT/RTs, physicians must be aware of the risk of postoperative intratumoral hemorrhage after performing ETV.
Trial registration number
E-2385 (2021/3/11)
Figure 1
Figure 2
This is a list of supplementary files associated with this preprint. Click to download.
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