IF 2.1 3区 医学 Q3 CLINICAL NEUROLOGY Journal of neurosurgery. Pediatrics Pub Date : 2025-02-28 DOI:10.3171/2024.12.PEDS24424
Kasper Amund Henriksen, Arani Kulamurugan, Maia Poon, Harishchandra Lalgudi Srinivasan, Adam J Fleming, Sheila K Singh, Gorm Von Oettingen, Jane Skjøth-Rasmussen, Conor Mallucci, René Mathiasen, Jon Foss-Skiftesvik
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引用次数: 0

摘要

目的:后窝肿瘤(PFTs)患儿的脑积水治疗通常采用脑室外引流管(EVD)置入术、内镜下第三脑室造口术(ETV)或单纯肿瘤切除术。然而,最佳治疗方法仍未确定。因此,本研究旨在探讨 PFTs 患儿术前脑积水处理与术后早期 CSF 转移和永久引流需求之间的关系:这项国际多中心回顾性队列研究纳入了 2008-2018 年在英国 Alder Hey 儿童医院、2011-2020 年在丹麦 Rigshospitalet 大学医院、2011-2020 年在丹麦奥胡斯大学医院和 2003-2020 年在加拿大麦克马斯特大学医学中心接受后窝肿瘤初次切除术的所有儿童患者(年龄小于 18 岁)。主要结果是术后早期脑脊液转流(肿瘤切除术后30天内的ETV、EVD或任何形式的分流)。次要结果是切除术后30天内的永久引流(脑室腹腔分流术)率。进行了单变量和多变量逻辑回归分析:共纳入 310 名患有 PFT 的儿童,其中 234 名(75.5%)在术前患有脑积水。85%以上的患儿在术前成功治疗了脑积水。38名患儿(12.3%)需要永久引流,术前接受 EVD 治疗的患儿发生率更高。然而,在术前脑积水处理方法的选择(EVD vs ETV vs 单纯肿瘤切除术)与术后需要早期脑脊液转流手术或永久性脑脊液引流术的持续性脑积水之间,并没有发现有统计学意义的关联:这项大型国际多中心研究并未证明术前脑积水处理方法的选择(EVD、ETV 或单纯肿瘤切除术)与肿瘤切除术后需要手术干预的持续性脑积水之间存在显著关联。
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Optimal management of hydrocephalus in children with posterior fossa tumors: an international retrospective multicenter study.

Objective: Hydrocephalus in children with posterior fossa tumors (PFTs) is commonly treated with extraventricular drain (EVD) placement, endoscopic third ventriculostomy (ETV), or tumor resection alone. However, the optimal treatment approach remains undetermined. Therefore, the objective of this study was to investigate the relationship between management of preoperative hydrocephalus in children with PFTs and the need for early postoperative CSF diversion and permanent drainage.

Methods: This international multicenter retrospective cohort study included all pediatric patients (aged < 18 years) who underwent primary resection of a posterior fossa tumor at Alder Hey Children's Hospital, United Kingdom, 2008-2018; Rigshospitalet University Hospital, Denmark, 2011-2020; Aarhus University Hospital, Denmark, 2011-2020; and McMaster University Medical Centre, Canada, 2003-2020. The primary outcome was early postoperative CSF diversion (ETV, EVD, or shunt of any kind within 30 days of tumor resection). The secondary outcome was the permanent drainage (ventriculoperitoneal shunt) rate within 30 days after resection. Univariate and multivariate logistic regression analyses were performed.

Results: In total, 310 children with PFTs were included, of whom 234 (75.5%) had preoperative hydrocephalus. Preoperative hydrocephalus was successfully treated in more than 85%. Thirty-eight children (12.3%) required permanent drainage, with a higher incidence in those treated with preoperative EVD. However, no statistically significant association was found between choice of preoperative hydrocephalus management (EVD vs ETV vs tumor resection alone) and persistent hydrocephalus requiring either early postoperative CSF diversion surgery or permanent CSF drainage.

Conclusions: This large international multicenter study did not demonstrate a significant association between choice of management of preoperative hydrocephalus (EVD, ETV, or tumor resection alone) and persisting hydrocephalus requiring surgical intervention after tumor resection.

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来源期刊
Journal of neurosurgery. Pediatrics
Journal of neurosurgery. Pediatrics 医学-临床神经学
CiteScore
3.40
自引率
10.50%
发文量
307
审稿时长
2 months
期刊介绍: Information not localiced
期刊最新文献
Building consensus regarding the definition of abnormal craniocervical motion in pediatric patients with Chiari malformation: a modified Delphi study. Comparative analysis of surgical approaches in nonsyndromic multiple-suture synostosis: a systematic review and meta-analysis. Letter to the Editor. The young Chiari patient, an oft-forced hand? Optimal management of hydrocephalus in children with posterior fossa tumors: an international retrospective multicenter study. The AANS/CNS Section on Pediatric Neurological Surgery domestic traveling fellowship: history and survey results of past recipients.
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