دورية أكاديمية
Management of Choroid Plexus Tumors and the Benefit of Preoperative Embolization in Pediatric Patients: Report of 46 Cases from a Single Institution.
| العنوان: | Management of Choroid Plexus Tumors and the Benefit of Preoperative Embolization in Pediatric Patients: Report of 46 Cases from a Single Institution. |
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| المؤلفون: | Slingerland AL; Department of Neurosurgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Papadakis JE; Department of Neurosurgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Staffa SJ; Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Scott RM; Department of Neurosurgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA., See AP; Department of Neurosurgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Orbach DB; Department of Neurointerventional Radiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Fehnel KP; Department of Neurosurgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA. Electronic address: Katie.Fehnel@childrens.harvard.edu. |
| المصدر: | World neurosurgery [World Neurosurg] 2024 Jan; Vol. 181, pp. e1071-e1087. Date of Electronic Publication: 2023 Nov 17. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: United States NLM ID: 101528275 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1878-8769 (Electronic) Linking ISSN: 18788750 NLM ISO Abbreviation: World Neurosurg Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: New York : Elsevier |
| مواضيع طبية MeSH: | Choroid Plexus Neoplasms*/surgery , Choroid Plexus Neoplasms*/complications , Hydrocephalus*/surgery , Hydrocephalus*/complications , Embolization, Therapeutic*/adverse effects , Papilloma, Choroid Plexus*/complications, Child ; Humans ; Lethargy/complications ; Blood Loss, Surgical ; Retrospective Studies |
| مستخلص: | Objective: Optimal choroid plexus tumor (CPT) treatment involves gross total resection; however, intraoperative hemorrhage risk remains significant given tumor vascularity. This study describes pediatric CPT management and identifies patients most likely to benefit from preoperative embolization. Methods: CPTs resected from 1997 to 2021 were included. The characteristics of embolized patients were compared to nonembolized patients; nonembolized patients were further stratified based on open vascular control-pedicle feeder ligation versus no pedicle ligation prior to tumor debulking. Statistical analyses identified factors associated with estimated blood loss (EBL), transfusion, length of stay, and complications. Results: Among the 46 CPT cases identified, 98% achieved gross total resection, and 15% received embolization. Embolized patients were younger, smaller, and had larger tumors compared to nonembolized patients (median: 0.8 vs. 2.1 years; 9.3 vs. 14.4 kg; 91.08 vs. 5.5 cm 3 ). Transfused patients were similarly younger and smaller (P < 0.05) than nontransfused patients. Among nonembolized patients, open vascular control was achieved in smaller tumors (<13 cm 3 ) with significantly lower EBL (P = 0.002). Higher EBL was observed in patients with larger tumors, hydrocephalus, transependymal edema, vomiting, lethargy, and developmental regression (all P < 0.05). Patients with lethargy had longer hospital stays and a higher likelihood of postoperative complications (P < 0.05). There were no significant differences in complication rates between the embolization and nonembolization groups. Conclusions: Despite higher surgical risk profiles, embolized patients had similar complication rates and postoperative hydrocephalus management as nonembolized patients. Embolization was particularly beneficial in patients at high risk for surgical morbidity, such as those <2 years, weighing <10 kg, and with a tumor volume >15 cm 3 . (Copyright © 2023 Elsevier Inc. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Choroid plexus carcinoma; Choroid plexus papilloma; Choroid plexus tumors; Embolization; Pediatrics |
| تواريخ الأحداث: | Date Created: 20231117 Date Completed: 20240118 Latest Revision: 20240702 |
| رمز التحديث: | 20240702 |
| DOI: | 10.1016/j.wneu.2023.11.044 |
| PMID: | 37977483 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1878-8769 |
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| DOI: | 10.1016/j.wneu.2023.11.044 |