Cerebrospinal fluid diversion prior to posterior fossa tumor resection in adults: A systematic review.

Autor:	Vastani A; Department of Neurosurgery, Queens Hospital, Romford, UK., Baig Mirza A; Department of Neurosurgery, Queens Hospital, Romford, UK., Ali F; GKT School of Medical Education, King's College London, London, UK., Iqbal A; GKT School of Medical Education, King's College London, London, UK., Sharma C; GKT School of Medical Education, King's College London, London, UK., Khizar Khoja A; GKT School of Medical Education, King's College London, London, UK., Vaqas B; Department of Neurosurgery, Queens Hospital, Romford, UK., Lavrador JP; Department of Neurosurgery, Kings College Hospital NHS Foundation Trust, Denmark Hill, UK., Pollock J; Department of Neurosurgery, Queens Hospital, Romford, UK.
Jazyk:	angličtina
Zdroj:	Neuro-oncology practice [Neurooncol Pract] 2024 Jun 20; Vol. 11 (6), pp. 703-712. Date of Electronic Publication: 2024 Jun 20 (Print Publication: 2024).
DOI:	10.1093/nop/npae055
Abstrakt:	Background: Posterior fossa tumors (PFTs) comprise 15%-20% of adult brain tumors, with the reported frequency of hydrocephalus (HCP) ranging between 3.7% and 58%. Most HCP resolves after resection of PFTs, but studies report persistent or new-onset HCP occurring in between 2% and 7% of cases. Preoperative cerebrospinal fluid (CSF) diversion with a ventriculoperitoneal shunt (VPS), external ventricular drain (EVD), or endoscopic third ventriculostomy (ETV) has been shown to improve outcomes. Evidence regarding the efficacy of these techniques is limited. Methods: A systematic literature search was performed in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Data points were extracted from individual patient cohort data. A failure rate was determined by the number of patients requiring further postoperative CSF diversion. Results: In total, 8863 records were identified. Thirteen studies consisting of 17 patient cohorts met our inclusion criteria. Across all individual cohort studies, 2976 patients underwent surgical resection of a PFT in whom the frequency of hydrocephalus at presentation was 22.98% (1.92%-100%), and persistent hydrocephalus following preoperative CSF diversion was 13.63% (0%-18%). Of the 684 hydrocephalic patients, 83.63% underwent CSF diversion in the form of ETV, EVD, or VPS. Between years 1992 and 2020, 1986 and 2021, and 1981and 2013, the pre-resection ETV, EVD, and VPS failure rates were 14.66% (17/116), 16.26% (60/369), and 0% (0/87), respectively. Conclusions: This systematic review highlights that VPS has a better failure rate profile in minimizing postoperative hydrocephalus in adult patients with PFTs. Competing Interests: None declared. (© The Author(s) 2024. Published by Oxford University Press on behalf of the Society for Neuro-Oncology and the European Association of Neuro-Oncology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
Databáze:	MEDLINE
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