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Frameless robot-assisted stereotactic biopsy: an effective and minimally invasive technique for pediatric diffuse intrinsic pontine gliomas

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Abstract

Purpose

Diffuse intrinsic pontine gliomas (DIPGs) are prone to high surgical risks, and they could even lead to death due to their specific sites. To determine the value of frameless robot-assisted stereotactic biopsies of DIPGs, when compared it with microsurgical biopsies.

Methods

We conducted a retrospective study of 71 pediatric patients who underwent biopsies from January 2016 to January 2021. (i) group 1: microsurgical biopsies, and (ii) group 2: frameless robot-assisted stereotactic biopsies. Demographic information, neuroimaging characteristics, pathological diagnoses, operation time, postoperative intensive care unit (ICU) stay time, postoperative hospitalization time, complications, cost, and perioperative mortality rate (POMR) were collected for analyses.

Results

32 Cases underwent microsurgical biopsies (group 1) and 39 cases underwent frameless robot-assisted stereotactic biopsies (group 2). All cases were accurately diagnosed after surgery. There was no significant difference in gender, age, symptom times and tumor volumes between the two groups (p > 0.05); operation time, postoperative ICU, stay time and postoperative hospitalization time were longer in group 1 than in group 2 (p < 0.001); the intraoperative bleeding volumes and cost were higher in group 1 than in group 2 (p < 0.001). Group 1 patients required more perioperative blood transfusion than group 2 (p = 0.001), and the new neurological impairments were more frequent in group 1 than in group 2 (p = 0.003). The POMR was 9.38% (3/32) in group 1 and 0 in group 2 (p = 0.087).

Conclusions

Frameless robot-assisted stereotactic biopsy was an effective and minimally invasive technique for pediatric DIPGs.

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Funding

This study was supported by Medical Innovation Research Project, Shanghai Science and Technology Innovation Plan of Action (Grant No. 22Y11904400).

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Authors and Affiliations

  1. Department of Neurosurgery, National Children’s Medical Center, Children’s Hospital of Fudan University, No.399 Wan Yuan Avenue, Minhang District, Shanghai, 201102, People’s Republic of China

    Min Wang, Yi Zhang, Wei Shi, Renqing Zhu, Hao Li & Rui Zhao

Authors
  1. Min Wang
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  2. Yi Zhang
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  3. Wei Shi
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  4. Renqing Zhu
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  5. Hao Li
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by WM, YZ, WS, RZ, HL and RZ. The first draft of the manuscript was written by MW and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Hao Li or Rui Zhao.

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Wang, M., Zhang, Y., Shi, W. et al. Frameless robot-assisted stereotactic biopsy: an effective and minimally invasive technique for pediatric diffuse intrinsic pontine gliomas. J Neurooncol 160, 107–114 (2022). https://doi.org/10.1007/s11060-022-04122-4

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