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Impact of three surgical approaches on the therapeutic efficacy of intraventricular craniopharyngiomas: a single-center retrospective analysis

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Abstract

This study aimed to investigate the therapeutic efficacy of three different surgical approaches for the treatment of intraventricular craniopharyngiomas (IVCs). The three surgical approaches investigated in this study were the endoscopic endonasal approach (EEA), pterional trans-lamina terminalis approach (PTA), and interhemispheric trans-lamina terminalis approach (ITA). Patient demographics, preoperative symptoms, endocrine and hypothalamic status, tumor characteristics, and surgical outcomes were analyzed and compared among the different surgical groups. A total of 31 patients with IVCs were included in the analysis, with 12 patients in the EEA group, 8 patients in the ITA group, and 11 patients in the PTA group. The mean follow-up time was 39 ± 23 months. Statistical analysis of the data revealed significant differences in the gross total resection (GTR) rate among the three surgical groups (P = 0.033). The GTR rate for the EEA group was 100%, that for the ITA group was 88%, and that for the PTA group was 64%, which was the lowest rate observed. After surgery, only 8.3% of the patients in the EEA group did not experience new postoperative hypopituitarism, while the percentages in the ITA and PTA groups were 75% and 73%, respectively (P = 0.012). Finally, we found that postoperative hypopituitarism may be related to the transection of the pituitary stalk during the operation (P = 0.020). Based on the results of this study, we recommend using the EEA and the ITA instead of the PTA for the surgical resection of IVCs. Furthermore, the appropriate surgical approach should be selected based on the tumor’s growth pattern.

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Acknowledgements

Thanks are due to Dr. Yongjian Chen from Karolinska, Sweden, for his generous guidance and help in the statistical analysis.

Funding

This work was supported by the National Natural Science Foundation of China (8227101086).

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Author notes

  1. Yiguang Chen and Xiaohai Liu contributed equally to this work and share first authorship.

Authors and Affiliations

  1. Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China

    Yiguang Chen, Xiaohai Liu, Mingchu Li, Hongqi Zhang & Ge Chen

  2. China International Neuroscience Institute (China-INI), Xuanwu Hospital, Capital Medical University, Xicheng District, Beijing, China

    Yiguang Chen, Xiaohai Liu, Mingchu Li, Hongqi Zhang & Ge Chen

  3. Dermatology and Venereology Division, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden

    Yongjian Chen

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Contributions

G. C. conceived and designed and guided the writing of the original article. YG. C. completed the figures and tables and wrote the article. X. L. and YJ. C. summarized and analyzed the data. M. L. assisted in writing the papers. H. Z. supervised the writing process of the article. All authors read and approved the final manuscript.

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Correspondence to Hongqi Zhang or Ge Chen.

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This retrospective study was approved by the Ethics Committee of Xuanwu Hospital, Capital Medical University, Beijing, China. Informed consent was obtained from all individual participants included in the study.

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Chen, Y., Liu, X., Li, M. et al. Impact of three surgical approaches on the therapeutic efficacy of intraventricular craniopharyngiomas: a single-center retrospective analysis. Neurosurg Rev 46, 238 (2023). https://doi.org/10.1007/s10143-023-02146-6

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