Surgical Outcome of Intraventricular Tumors; A Retrospective Single Center Study in Addis Ababa, Ethiopia

Abstract

Background: Intraventricular tumors (IVT) are rare clinical entities; surgical resection remains challenging for neurosurgeons. Knowledge about the surgical outcome of these tumors in resource-limited settings is scarce. The study aims to do quality control of surgical management of IVT in a single neurosurgical center in Ethiopia. Methods: This study employed a hospital-based retrospective review of 40 patients who underwent surgical treatment for intraventricular tumors (IVT) at Tikur Anbesa Specialized Hospital between January 2015 and December 2020. Descriptive statistics used to evaluate the clinical presentation, imaging, histology, surgical approach, complications, mortality, overall survival and risk factors for poor outcome. Results: The median age was 19 years (range: 1-52 years). Headache was the most common presenting symptom (95%), followed by visual disturbance (65%). Supratentorial tumors accounted for 52.5% of cases, with medulloblastomas being the most frequent subtype (n=11). The overall complication rate was 52.5%, with hydrocephalus (40%) and infections (25%) being the most common postoperative complications. The 30-day operative mortality rate was 27.5%. Risk factors for complications and mortality included infratentorial tumor location, subtotal resection, EVD insertion, and longer ICU stay. Postoperative hydrocephalus independently predicted operative mortality. Conclusion: This study reveals higher complication and mortality rates for Intraventricular tumor (IVT) surgeries, especially for infratentorial tumors. Limited resources and experience contribute to these concerning outcomes. Postoperative hydrocephalus is identified as an independent risk factor for 30-day mortality. The findings highlight the challenges of managing IVT surgically in resource-limited settings, emphasizing the need for serious consideration and proper management to achieve better outcomes.