gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

The role of endoscopy in the management of intra- and periventricular tumors

Die Rolle der Endoskopie in der Behandlung intra- und periventrikulärer Tumore

Meeting Abstract

  • corresponding author V. Rohde - Neurochirurgische Klinik des Universitätsklinikums der RWTH Aachen
  • V. Coenen - Neurochirurgische Klinik des Universitätsklinikums der RWTH Aachen
  • M. Weinzierl - Neurochirurgische Klinik des Universitätsklinikums der RWTH Aachen
  • Y. Ryang - Neurochirurgische Klinik des Universitätsklinikums der RWTH Aachen
  • J. M. Gilsbach - Neurochirurgische Klinik des Universitätsklinikums der RWTH Aachen

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc09.05.-16.02

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2005/05dgnc0077.shtml

Published: May 4, 2005

© 2005 Rohde et al.
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Outline

Text

Objective

The operative therapy of ventricular tumors is still a challenge for the neurosurgeon. The transcallosal approach has a certain morbidity rate, which increases substantially in tumors of subependymal origin. Possibly, neuroendoscopy alone or in combination with adjuvant therapies offers the chance of treating some of these patients less invasively but still effectively. Therefore it was the purpose of this prospective clinical series to investigate the role of neuroendoscopy in the management of intra- and periventricular tumors.

Methods

In 36 patients with intra- or periventricular tumors (low-grade glioma n=16; craniopharnyngeoma n=8; high-grade glioma n=6; lymphoma n=2, germinoma, pituitary adenoma, granuloma, metastasis n=1 each) a biopsy was taken endoscopically. In 21 patients with tumor-associated hydrocephalus, a septostomy and/or third ventriculostomy were performed. Tumor cysts were opened to the ventricular system in 11 patients. In patients with non-benign tumors, radio- or chemotherapy were initiated after surgery. Patients with craniopharyngeomas underwent radiotherapy of the solid tumor remnant.

Results

There was no operative morbidity or mortality. Biopsy was conclusive in 35 of the 36 patients. Hydrocephalus was successfully controlled in 17 of the 21 patients. After initial clinical improvement after surgery in all cases, 3 patients deteriorated again during the hospital stay (cyst refilling, tumor growth, intratumoral bleeding n=1 each). Five of 6 patients with high-grade glioma survived 6-9 months, 1 patient more than 1.5 years. After a mean follow-up of 1.5 years, the clinical results of the remaining patients are stable.

Conclusions

In intra- and periventricular tumors, endoscopy with or without adjuvant therapy proved to be a very safe and nonetheless effective approach. Endoscopy should at least be taken into account when dealing with ventricular tumors.