scholarly journals Application of Endoport-Assisted Neuroendoscopic Techniques in Lateral Ventricular Tumor Surgery

2021 ◽  
Author(s):  
Chaolong Yan ◽  
Huiying Yan ◽  
Wei Jin
Keyword(s):  
Perioperative Complications ◽  
Obstructive Hydrocephalus ◽  
Image Data ◽  
Complete Removal ◽  
Postoperative Recovery ◽  
Neuroendoscopic Surgery ◽  
Drum Tower Hospital ◽  
Ventricular Tumors ◽  
Acute Epidural Hematoma ◽  
Subtotal Removal

Abstract PurposeThe aim of this study was to review the experience of Endoport-assisted neuroendoscopic surgery for lateral ventricular tumors resection, investigate the therapeutic efficiency and discuss the key points. MethodsWe retrospectively reviewed the clinical data of 16 patients suffering from lateral ventricular tumors. All the patients received Endoport-assisted neuroendoscopic surgery from January 2018 to June 2020 in the department of neurosurgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School. ResultsAll the patients received standardized treatment according to the preoperative image data and the postoperative pathology of the tumors. Endoport-assisted Neuroendoscopic surgery achieved complete removal of lateral ventricular tumors in 14 cases (87.5%) and subtotal removal in 2 cases (12.5%, glioma). The perioperative complications were analyzed, 1 acute epidural hematoma occurred during surgery, 1 hemiplegia and 2 obstructive hydrocephalus occurred after surgery. All the complications were managed timely. During the long-time follow up, the patient with glioblastoma died 16 months after surgery, the other patients are still alive with Glasgow outcome scales not less than 4.ConclusionEndoport-assisted neuroendoscopic surgery is suitable for the resection of lateral ventricular tumors. This procedure is simple, effective, minimally invasive, and associated with fast postoperative recovery.

scholarly journals STMO-07 Adverse events related to the glioblastoma surgery and their perioperative management in our hospital

2020 ◽  
Vol 2 (Supplement_3) ◽  
pp. ii10-ii10
Author(s):  
Hideki Kashiwagi ◽  
Shinji Kawabata ◽  
Seigo Kimura ◽  
Ryokichi Yagi ◽  
Naokado Ikeda ◽  
...  
Keyword(s):  
Adverse Events ◽  
Venous Thrombosis ◽  
Perioperative Management ◽  
Perioperative Complications ◽  
Epileptic Seizures ◽  
Residual Tumor ◽  
Complete Removal ◽  
Tumor Localization ◽  
Vein Thrombosis ◽  
Before And After

Abstract Background: The standard treatment for glioblastoma is surgical resection following chemoradiation therapy. The rate of removal or the amount of residual tumor has some impact on the prognosis of patients with glioblastoma, but the highly invasive nature of this tumor makes complete removal limited to the contrast-enhanced lesions difficult due to its localization. Furthermore, when postoperative seizures and venous thrombosis are included in surgery-related complications, these perioperative adverse events can cause delays in the initiation of chemoradiotherapy and delay the return to work and home, such as prolonged hospitalization and rehabilitation time. Methods: We retrospectively reviewed the perioperative status of the recent 50 consecutive cases with histologically confirmed as glioblastoma at our hospital, the patient background, tumor localization, and perioperative treatment, and so on. Results: The major perioperative complications were ischemic or hemorrhagic complications, epileptic seizures, venous thrombosis, and pneumonia; CTCAE grade 2 or higher, grade 3 or higher, and grade 4 occurred in about 40%, 20%, and 10%, respectively, with some patients having multiple complications. Discussion: Although there was a tendency for ischemic changes around the cavity of the resection as the resection rate increased, most cases were asymptomatic and it seemed to be acceptable if residual brain function could be preserved. Residual tumors tended to show hemorrhagic changes and epileptic seizures because this is thought to be that the tumor was deliberately left in place to preserve function, based on the localization of the tumor. Postoperative FDP levels were useful in predicting the development of deep vein thrombosis and pulmonary artery thromboembolism. Conclusion: Because glioblastoma has short survival time and patient PS before and after surgery varies greatly depending on tumor localization, it is important to consider risk-benefit strategies for each case and to establish a scheme for a seamless transition from perioperative management to the introduction of postoperative therapy and maintenance therapy.

scholarly journals Endoscopic treatment of a third ventricle choroid plexus cyst

2013 ◽  
Vol 34 (v1supplement) ◽  
pp. 1 ◽  
Author(s):  
Danielle de Lara ◽  
Leo F. S. Ditzel Filho ◽  
Jun Muto ◽  
Daniel M. Prevedello
Keyword(s):  
Choroid Plexus ◽  
Obstructive Hydrocephalus ◽  
Adult Population ◽  
Third Ventricle ◽  
Postoperative Recovery ◽  
Current Treatment ◽  
Posterior Portion ◽  
Cerebrospinal Fluid Flow ◽  
Patient Reports ◽  
The Third

Choroid plexus cysts are frequent benign intraventricular lesions that infrequently cause symptoms, usually in the form of obstructive hydrocephalus. These instances are even less common in the adult population. When warranted, treatment seeks to reestablish cerebrospinal fluid flow and does not necessarily require resection of the cyst itself. Hence, endoscopic exploration of the ventricles with subsequent cyst ablation is the current treatment of choice for these lesions.Herein we present the case of a 25-year-old female patient with a 3-week history of intermittent headaches. Investigation with computerized tomography (CT) of the head detected supratentorial hydrocephalus, with enlargement of the lateral and third ventricles. Magnetic resonance imaging revealed a homogeneous cystic lesion in the third ventricle. A right-sided, pre-coronal burr hole was carried out, followed by endoscopic exploration of the ventricular system. A third-ventriclostomy was performed. With the aid of the 30-degrees endoscope, a cyst arising from the choroid plexus was visualized along the posterior portion of the third ventricle, obstructing the aqueduct opening. The cyst was cauterized until significant reduction of its dimensions was achieved and the aqueduct opening was liberated. Postoperative recovery was without incident and resolution of the hydrocephalus was confirmed by CT imaging. The patient reports complete improvement of her headaches and has been uneventfully followed since surgery.The video can be found here: http://youtu.be/XBtj_SqY07Q.

PS01.159: THE IMPROVED POSTOPERATIVE RECOVERY OUTCOMES FROM MINIMALLY INVASIVE ESOPHAGECTOMY

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 94-94
Author(s):  
Xiaobin Zhang ◽  
Zhigang Li
Keyword(s):  
Minimally Invasive ◽  
Anastomotic Leakage ◽  
Conflicts Of Interest ◽  
Perioperative Complications ◽  
Minimally Invasive Esophagectomy ◽  
Postoperative Recovery ◽  
Open Group ◽  
Recurrent Nerve ◽  
Invasive Esophagectomy ◽  
Open Esophagectomy

Abstract Background The minimally invasive esophagectomy (MIE) has been developed in the past three decades. In our institution, the MIE was first introduced in 2012, and the proportion of MIE was used for over 70% in 2016–2017. This study aimed to compare the postoperative recovery outcomes between MIE and open esophagectomy in different period. Methods A total of 725 patients were enrolled in this study including 248 patients who underwent open esophagectomy within 2012–2013 and 477 patients who underwent MIE within 2016–2017. All patients received McKeown esophagectomy with two-field lymphadenectomy. And the perioperative complications were recorded according to the Esophagectomy Complications Consensus Group (ECCG) complication definitions. Results There was no statistically difference between OPEN and MIE groups with regard to preoperative characters except for age (60.8 ± 7.2 vs. 62.7 ± 7.7, P < 0.001) and body mass index (22.4 ± 3.0 vs. 23.1 ± 3.0, P = 0.002). One (0.2%) patient in the MIE group died within 90 days from anastomotic leakage, compared to 6 (2.4%) patients in the OPEN group (P = 0.004). The length of hospital stay was shorter in the MIE group (11 range 6–131 days, vs. 15 range 9–164 days, P < 0.001). The MIE group was in favor of lower complications (32.3% vs. 46.4%, P < 0.001). Pneumonia was the most common complications in both groups (12.6% in MIE vs. 27.4% in OPEN, P < 0.001). 15 (3.1%) patients in the MIE group experienced atrial arrhythmias compared with 30 (12.1%) in the OPEN group (P < 0.001). Lower anastomotic leakage was noted in the MIE group (11.5% vs. 25.4%, P < 0.001), as well as the wound infection (0.2% vs. 2.8%, P = 0.001), than in the OPEN group. The recurrent nerve injury was higher in the MIE group (11.7% vs. 6.5%, P = 0.024) but with more lymph nodes dissection along the recurrent laryngeal nerve (3.8 ± 2.8 vs. 1.4 ± 2.0, P < 0.001). Conclusion The MIE was associated with better postoperative recovery outcomes and lower mortality. MIE technique should be considered as the mainstay surgical treatment for esophageal cancer in the current and future period. Disclosure All authors have declared no conflicts of interest.

scholarly journals Stereotactic laser ablation for hypothalamic and deep intraventricular lesions

2016 ◽  
Vol 41 (4) ◽  
pp. E10 ◽  
Author(s):  
Robert T. Buckley ◽  
Anthony C. Wang ◽  
John W. Miller ◽  
Edward J. Novotny ◽  
Jeffrey G. Ojemann
Keyword(s):  
Laser Ablation ◽  
Obstructive Hydrocephalus ◽  
Invasive Procedure ◽  
Mesial Temporal Lobe Epilepsy ◽  
Tumor Control ◽  
Hypothalamic Hamartoma ◽  
Subependymal Giant Cell Astrocytoma ◽  
Seizure Freedom ◽  
Long Term Follow Up ◽  
Ventricular Tumors

OBJECTIVE Laser ablation is a novel, minimally invasive procedure that utilizes MRI-guided thermal energy to treat epileptogenic and other brain lesions. In addition to treatment of mesial temporal lobe epilepsy, laser ablation is increasingly being used to target deep or inoperable lesions, including hypothalamic hamartoma (HH), subependymal giant cell astrocytoma (SEGA), and exophytic intrinsic hypothalamic/third ventricular tumors. The authors reviewed their early institutional experience with these patients to characterize clinical outcomes in patients undergoing this procedure. METHODS A retrospective cohort (n = 12) of patients undergoing laser ablation at a single institution was identified, and clinical and radiographic records were reviewed. RESULTS Laser ablation was successfully performed in all patients. No permanent neurological or endocrine complications occurred; 2 (17%) patients developed acute obstructive hydrocephalus or shunt malfunction following treatment. Laser ablation of HH resulted in seizure freedom (Engel Class I) in 67%, with the remaining patients having a clinically significant reduction in seizure frequency of greater than 90% compared with preoperative baseline (Engel Class IIB). Treatment of SEGAs resulted in durable clinical and radiographic tumor control in 2 of 3 cases, with one patient receiving adjuvant everolimus and the other receiving no additional therapy. Palliative ablation of hypothalamic/third ventricular tumors resulted in partial tumor control in 1 of 3 patients. CONCLUSIONS Early experience suggests that laser ablation is a generally safe, durable, and effective treatment for patients harboring HHs. It also appears effective for local control of SEGAs, especially in combination therapy with everolimus. Its use as a palliative treatment for intrinsic hypothalamic/deep intraventricular tumors was less successful and associated with a higher risk of serious complications. Additional experience and long-term follow-up will be beneficial in further characterizing the effectiveness and risk profile of laser ablation in treating these lesions in comparison with conventional resective surgery or stereotactic radiosurgery.

Efficacy and Safety of Endoscopic Transventricular Lamina Terminalis Fenestration for Hydrocephalus

Neurosurgery ◽  
2012 ◽  
Vol 71 (2) ◽  
pp. 464-473 ◽  
Author(s):  
Leonardo Rangel-Castilla ◽  
Steven W. Hwang ◽  
Andrew Jea ◽  
Jaime Torres-Corzo
Keyword(s):  
Ventriculoperitoneal Shunt ◽  
Perioperative Complications ◽  
Obstructive Hydrocephalus ◽  
Third Ventricle ◽  
Significant Risk ◽  
Good Alternative ◽  
Aqueductal Stenosis ◽  
Third Ventriculostomy ◽  
Lamina Terminalis ◽  
Transforaminal Approach

Abstract BACKGROUND: Endoscopic third ventriculostomy (ETV) has become the procedure of choice in the treatment of obstructive hydrocephalus. In certain cases, standard ETV might not be technically possible or may engender significant risk. OBJECTIVE: To present an alternative through the lamina terminalis (LT) by a transventricular, transforaminal approach with flexible neuroendoscopy and to discuss the indications, technique, neuroendoscopic findings, and outcomes. METHODS: Between 1994 and 2010, all patients who underwent endoscopic LT fenestration as an alternative to ETV were analyzed and prospectively followed up. The decision to perform an LT fenestration was made intraoperatively. RESULTS: Twenty-five patients, ranging in age from 7 months to 76 years (mean, 28.1 years), underwent endoscopic LT fenestration. Patients had obstructive hydrocephalus secondary to neurocysticercosis (11 patients), neoplasms (6 patients), congenital aqueductal stenosis (3 patients), and other (5 patients). Thirteen patients (52%) had had at least 1 ventriculoperitoneal shunt that malfunctioned; 6 patients (24%) had undergone a previous endoscopic procedure. Intraoperative findings that led to an LT fenestration were the following: ETV not feasible to perform, basal subarachnoid space not sufficient, or adhesions in the third ventricle. No perioperative complications occurred. The mean follow-up period was 63.76 months. Overall, 19 patients (76%) had resolutions of symptoms, had no evidence of ventriculomegaly, and did not require another procedure. Six (24%) required a ventriculoperitoneal shunt. CONCLUSION: Endoscopic transventricular transforaminal LT fenestration with flexible neuroendoscopy is feasible with a low incidence of complications. It is a good alternative to standard ETV. Adequate intraoperative assessment of ETV success is necessary to identify patients who will benefit.

scholarly journals Surgical treatment of unusual osteoma associated with homolateral radicular cyst of the maxillary sinus

2020 ◽  
Vol 26 (3) ◽  
pp. 30
Author(s):  
Elena Cantone ◽  
Aldo Torrisi ◽  
Antonio Romano ◽  
Antonia Cama ◽  
Giulia Foschi ◽  
...  
Keyword(s):  
Growth Factors ◽  
Maxillary Sinus ◽  
Surgical Approach ◽  
Histopathological Examination ◽  
Periodontal Regeneration ◽  
Complete Removal ◽  
Postoperative Recovery ◽  
Nasal Endoscopy ◽  
Radicular Cyst ◽  
The Right

Introduction: We described a rare clinical case of osteoma associated with homolateral radicular cyst of the maxillary sinus. Observation: Imaging showed two different lesions in the right maxillary sinus. We performed a combined surgical approach to completely remove the lesions and used a plasma rich in growth factors membrane to repair dental roots. No relapse after a 2 years follow-up was observed. Commentaries: The simultaneous presence of two large lesions, a 23,7 mm osteoma and a 33,7 mm radicular cyst in the same maxillary sinus, has been rarely described in the literature. Although nasal endoscopy and imaging are mandatory to assess the diagnosis, the definitive diagnosis was obtained after histopathologic examination. A combined surgical approach allowed a complete removal of both lesions, ensuring, at same time, an optimal surgical field. Plasma rich in growth factors membrane due to its cohesive properties was particularly useful in improving bone neoformation and periodontal regeneration. Conclusion: Diagnostic assessment of maxillary lesions requires nasal endoscopy, imaging and histopathological examination. If these lesions are symptomatic, they should be completely removed and minimally invasive surgery is indicated. Plasma rich in growth factors membrane ensures a good postoperative recovery.

scholarly journals Combined rigid and flexible endoscopy for tumors in the posterior third ventricle

2015 ◽  
Vol 122 (6) ◽  
pp. 1341-1346 ◽  
Author(s):  
Jonathan Roth ◽  
Shlomi Constantini
Keyword(s):  
Endoscopic Third Ventriculostomy ◽  
Obstructive Hydrocephalus ◽  
Third Ventricle ◽  
Choroid Plexus Papilloma ◽  
Flexible Endoscopy ◽  
Endoscopic Biopsy ◽  
Third Ventriculostomy ◽  
Low Grade ◽  
Rigid Endoscope ◽  
Ventricular Tumors

OBJECT Tumors leading to occlusion of the sylvian aqueduct include those of pineal, thalamic, and tectal origins. These tumors cause obstructive hydrocephalus and thus necessitate a CSF diversion procedure such as an endoscopic third ventriculostomy (ETV), often coupled with an endoscopic biopsy (EBX). Lesions located posterior to the massa intermedia pose a technical challenge, as the use of a rigid endoscope for performing both an ETV and EBX is limited. The authors describe their experience using a combined rigid and flexible endoscopic procedure through a single bur hole for both procedures in patients with posterior third ventricular tumors. METHODS Since January 2012, patients with posterior third ventricular tumors causing hydrocephalus underwent dual ETV and EBX procedures using the combined rigid-flexible endoscopic technique. Following institutional review board approval, data from clinical, radiological, surgical, and pathological records were retrospectively collected. RESULTS Six patients 3.5–53 years of age were included. Lesion locations included pineal (n = 3), fourth ventricle (n = 1), aqueduct (n = 1), and tectum (n = 1). The ETV and EBX were successful in all cases. Pathologies included pilocytic astrocytoma, pineoblastoma, ependymoma Grade II, germinoma, low-grade glioneural tumor, and atypical choroid plexus papilloma. One patient experienced an immediate postoperative intraventricular hemorrhage necessitating evacuation of the clots and resection of the tumor, eventually leading to the patient's death. CONCLUSIONS The authors recommend using a combined rigid-flexible endoscope for endoscopic third ventriculostomy and biopsy to approach posterior third ventricular tumors (behind the massa intermedia). This technique overcomes the limitations of using a rigid endoscope by reaching 2 distant regions.

scholarly journals Neuroendoscopic Resection of Intraventricular Tumors and Cysts through a Working Channel with a Variable Aspiration Tissue Resector: A Feasibility and Safety Study

2013 ◽  
Vol 2013 ◽  
pp. 1-8
Author(s):  
Edjah Kweku-Ebura Nduom ◽  
Eric A. Sribnick ◽  
D. Ryan Ormond ◽  
Costas G. Hadjipanayis
Keyword(s):  
Cerebrospinal Fluid ◽  
Fluid Flow ◽  
Ventriculoperitoneal Shunt ◽  
Obstructive Hydrocephalus ◽  
Complete Removal ◽  
Burr Hole ◽  
Initial Experience ◽  
Safety Study ◽  
Cerebrospinal Fluid Flow ◽  
Intraventricular Tumors

Pure neuroendoscopic resection of intraventricular lesions through a burr hole is limited by the instrumentation that can be used with a working channel endoscope. We describe a safety and feasibility study of a variable aspiration tissue resector, for the resection of a variety of intraventricular lesions. Our initial experience using the variable aspiration tissue resector involved 16 patients with a variety of intraventricular tumors or cysts. Nine patients (56%) presented with obstructive hydrocephalus. Patient ages ranged from 20 to 88 years (mean 44.2). All patients were operated on through a frontal burr hole, using a working channel endoscope. A total of 4 tumors were resected in a gross total fashion and the remaining intraventricular lesions were subtotally resected. Fifteen of 16 patients had relief of their preoperative symptoms. The 9 patients who presented with obstructive hydrocephalus had restoration of cerebrospinal fluid flow though one required a ventriculoperitoneal shunt. Three patients required repeat endoscopic resections. Use of a variable aspiration tissue resector provides the ability to resect a variety of intraventricular lesions in a safe, controlled manner through a working channel endoscope. Larger intraventricular tumors continue to pose a challenge for complete removal of intraventricular lesions.

scholarly journals Predictors of hydrocephalus after lateral ventricular tumor resection

2021 ◽  
Author(s):  
Chengda Zhang ◽  
Lingli Ge ◽  
Tingbao Zhang ◽  
Zhengwei Li ◽  
Jincao Chen
Keyword(s):  
Risk Factors ◽  
Ventriculoperitoneal Shunt ◽  
Malignant Tumors ◽  
Obstructive Hydrocephalus ◽  
Tumor Resection ◽  
External Ventricular Drainage ◽  
Postoperative Hemorrhage ◽  
Ventricular Tumors ◽  
Independent Risk Factors ◽  
Postoperative Hydrocephalus

Abstract The aim of this study was to identify the predictors of postoperative hydrocephalus in patients with lateral ventricular tumors (LVTs) and to guide the management of perioperative hydrocephalus. We performed a retrospective analysis of patients who received LVT resection at the Department of Neurosurgery, Zhongnan Hospital of Wuhan University between January 2011 and March 2021. Patients were divided between a prophylactic external ventricular drainage (EVD) group and a non-prophylactic EVD group. We analyzed the non-prophylactic EVD group to identify predictors of acute postoperative hydrocephalus. We analyzed all enrolled patients to determine predictors of postoperative ventriculoperitoneal shunt placement. A total of 97 patients were included in this study. EVD was performed in 23 patients with postoperative acute obstructive hydrocephalus, nine patients with communicative hydrocephalus, and two patients with isolated hydrocephalus. Logistic regression analysis showed that tumor anterior invasion of the ventricle (P = 0.020) and postoperative hemorrhage (P = 0.004) were independent risk factors for postoperative acute obstructive hydrocephalus, while a malignant tumor (P = 0.004) was an independent risk factor for a postoperative ventriculoperitoneal shunt. In conclusion, anterior invasion of the lateral ventricle and postoperative hemorrhage are independent risk factors for acute obstructive hydrocephalus after LVT resection. Patients with malignant tumors have a greater risk of shunt dependence after LVT resection.

Giant Basilar Artery Aneurysm Presenting as a Third Ventricular Tumor

Neurosurgery ◽  
1983 ◽  
Vol 13 (6) ◽  
pp. 699-702 ◽  
Author(s):  
Bikash Bose ◽  
Bruce Northrup ◽  
Jewell Osterholm
Keyword(s):  
Basilar Artery ◽  
Obstructive Hydrocephalus ◽  
Artery Aneurysm ◽  
Giant Aneurysm ◽  
Giant Aneurysms ◽  
Basilar Artery Aneurysm ◽  
Unusual Phenomenon ◽  
Ventricular Tumors ◽  
Mass Lesions ◽  
Third Ventricular Tumor

Abstract Giant aneurysm of the basilar artery presenting as a 3rd ventricular tumor is an unusual phenomenon. We are reporting a case in which a patient with a giant aneurysm of the basilar artery presented with symptoms of headaches and gait disturbance secondary to obstructive hydrocephalus. Although giant aneurysms presenting as mass lesions have been reported, the computed axial tomographic findings in our case were unique. Giant aneurysms of the basilar artery may be considered in the differential diagnosis of 3rd ventricular tumors.

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