Issa Mohammed, Dannehl Clara, Büsken Carmen J, Ueding Nieke, Seitz Angelika, Krieg Sandro M, Unterberg Andreas W, El Damaty Ahmed
Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany.
Faculty of Medicine, Heidelberg University, Heidelberg, Germany.
Brain Spine. 2024 Nov 22;4:104142. doi: 10.1016/j.bas.2024.104142. eCollection 2024.
Neuroendoscopy has become a well-established procedure for treating various intracranial conditions.
We evaluated the advantages of that technique, with focus on adverse events.
Retrospective analysis included all patients who underwent neuroendoscopic procedures between January 2017 and December 2023. We conducted comparative analysis considering factors such as age, gender, follow-up duration, etiology, preoperative symptoms, clinical and radiological benefits, as well as surgical and nonsurgical adverse events rates.
Total of 318 neuroendoscopic procedures within 257 surgeries in 225 patients were included, with mean age of 18.8 ± 21.4 years. 170 cases (66.1%) were pediatric versus 87 cases adults (33.9%). Most common aetiologies were peri- and intraventricular cysts (27.2%), idiopathic aqueduct stenosis (24.9%), tumours (23.7%), and post-haemorrhagic hydrocephalus (17.1%). Procedures included endoscopic third ventriculostomy (51.0%), cyst fenestration (21.0%), and endoscopic-assisted ventricular catheter placements (19.5%). Headache was predominant preoperative symptom (42.0%). During follow-up, 84.8% and 82.5% of cases showed clinical and radiological improvement, respectively. Early surgical adverse events were observed in 5.4% of cases, while non-surgical adverse events occurred in 3.1%. There was no significant difference in the surgical adverse events rate between children and adults (4.7% vs. 6.9%, p = 0.563), compared to significant higher non-surgical adverse events in adults (6.9% vs 1.2%, ).
Neuroendoscopy has demonstrated effectiveness and safety in treating intracranial diseases, boasting a low adverse events rate. Our study found no significant difference in the surgical adverse events rates between pediatric and adult groups.
神经内镜已成为治疗各种颅内疾病的成熟方法。
我们评估了该技术的优势，重点关注不良事件。
回顾性分析纳入了2017年1月至2023年12月期间接受神经内镜手术的所有患者。我们进行了比较分析，考虑了年龄、性别、随访时间、病因、术前症状、临床和影像学获益以及手术和非手术不良事件发生率等因素。
共纳入225例患者的257次手术中的318例神经内镜手术，平均年龄为18.8±21.4岁。170例（66.1%）为儿童患者，87例（33.9%）为成人患者。最常见的病因是脑室周围和脑室内囊肿（27.2%）、特发性导水管狭窄（24.9%）、肿瘤（23.7%）和出血后脑积水（17.1%）。手术包括内镜下第三脑室造瘘术（51.0%）、囊肿开窗术（21.0%）和内镜辅助脑室置管术（19.5%）。头痛是主要的术前症状（42.0%）。随访期间，分别有84.8%和82.5%的病例显示临床和影像学改善。5.4%的病例观察到早期手术不良事件，而非手术不良事件发生率为3.1%。儿童和成人的手术不良事件发生率无显著差异（4.7%对6.9%，p = 0.563），而成人的非手术不良事件发生率显著更高（6.9%对1.2%）。
神经内镜在治疗颅内疾病方面已证明有效且安全，不良事件发生率低。我们的研究发现儿童组和成人组的手术不良事件发生率无显著差异。
