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Acta Neurochirurgica

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01-03-2011 | Clinical Article

Stereotactic versus endoscopic surgery in periventricular lesions

Authors: Thomas M. Kinfe, Hans-Holger Capelle, M. Javad Mirzayan, Jürgen Boschert, Ralf Weigel, Joachim K. Krauss

Published in: Acta Neurochirurgica | Issue 3/2011

Abstract

Object

Endoscopic and stereotactic surgery have gained widespread acceptance as minimally invasive tools for the diagnosis of intracerebral pathologies. We investigated the specific advantages and disadvantages of each technique in the assessment of periventricular lesions.

Method

This study included a retrospective series of 70 patients with periventricular lesions. Endoscopic surgery was performed in 17 patients (mean age, 37 years; range, 4 months–78 years) and stereotactic biopsy in 55 patients (mean age, 63 years; range, 23–80 years), including two patients who underwent both procedures.

Results

Hydrocephalus was present in 13/17 patients in the endoscopic group (77%) and in 11/55 patients in the stereotactic group (20%). Diagnosis was achieved in all patients in the endoscopic group and in all but one patient in the stereotactic group, in whom histological diagnosis was obtained by endoscopic biopsy during a second operation. In the endoscopic group, additional procedures performed included ventriculostomy (2/17), cyst fenestration (3/17), endoscopic shunt revision (3/17) and placement of Rickham reservoirs or external cerebrospinal fluid drains (6/17). Adverse events occurred in one patient after endoscopy (chronic subdural hematoma) and in two patients after stereotactic surgery (one mild hemiparesis and one transitory paresis of the contralateral leg).

Conclusions

Endoscopic and stereotactic surgery have distinct advantages and disadvantages in approaching periventricular lesions. The advantages of endoscopy encompass the possibility to perform additional surgical procedures during the same session (e.g. tumour reduction, third ventriculostomy, fenestration of a cyst). The visual control reduces the hazard of injury to anatomical structures and allows for a better control of bleeding although there is a considerable blind-out in such situations. The advantages of stereotactic surgery include a smaller approach and precise planning of the trajectory. It is usually performed under local anaesthesia. Both methods provide a safe and efficient therapeutic option in periventricular lesions with low surgical-related morbidity.

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Title: Stereotactic versus endoscopic surgery in periventricular lesions
Authors: Thomas M. Kinfe
Hans-Holger Capelle
M. Javad Mirzayan
Jürgen Boschert
Ralf Weigel
Joachim K. Krauss
Publication date: 01-03-2011
Publisher: Springer Vienna
Published in: Acta Neurochirurgica / Issue 3/2011
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-010-0933-x

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Springer Medicine

Stereotactic versus endoscopic surgery in periventricular lesions

Abstract

Object

Method

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Object

Method

Results

Conclusions

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