Endoscope-assisted Transcranial Surgery for Petroclival Meningiomas: a Single Centre Experience.

IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery Pub Date : 2025-09-27 DOI:10.1016/j.wneu.2025.124516

Xiaoyu Ji, Siyuan Yang, Peng Zhou, Mingzhe Sun, Liang Sun, Weiwei Zhai, Zhengquan Yu, Jiang Wu

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引用次数: 0

Abstract

Objective: The surgical management of petroclival meningioma (PCM) remains a challenge in neurosurgery. This study compared the outcomes of endoscope-assisted microsurgery and conventional microscopic approaches to evaluate the safety and efficacy of endoscope-assisted transcranial techniques for PCM treatment.

Methods: This retrospective case-control study was conducted at our hospital. Clinical data from January 2018 and June 2024 were retrospectively analysed. The primary outcome was gross total resection (GTR) rate, and the secondary outcomes included patient status, tumour progression or recurrence. Propensity score matching (PSM) was used to account for group differences.

Results: We enrolled 62 patients; 18 underwent endoscope-assisted transcranial surgery and 44 underwent transcranial microscopic surgery. The endoscope-assisted transcranial microsurgery group exhibited a higher GTR rate, shorter postoperative hospital stay, and lower tumour progression or recurrence rates than the transcranial microscopic surgery group (GTR: 83.3% vs. 52.3%, p = 0.046; postoperative hospital stay duration: 9.50 d [8.00, 13.75] vs. 13.00 d [10.00, 17.25], p=0.023; and lower tumour progression or recurrence: 11.1% vs. 50%, p = 0.01). After PSM, the endoscope-assisted surgery group had a better GTR rate, compared with the microsurgery group (odds ratio (OR): 7.51 [1.37, 41.10], 95% confidence interval: 1.37-41.10, p = 0.021).

Conclusion: Petroclival meningioma remains a surgical challenge. Endoscope-assisted microsurgery provides an increased GTR rate, offering excellent visualisation and access to tumours. Therefore, it may be recommended as a first-line treatment for patients with PCM.

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内窥镜辅助下经颅手术治疗岩斜坡脑膜瘤：单中心经验。

目的：岩斜坡脑膜瘤（PCM）的外科治疗仍是神经外科的一个挑战。本研究比较了内窥镜辅助下的显微手术和常规显微手术的结果，以评估内窥镜辅助下经颅技术治疗PCM的安全性和有效性。方法：在我院进行回顾性病例对照研究。回顾性分析2018年1月至2024年6月的临床数据。主要结果是总切除（GTR）率，次要结果包括患者状态、肿瘤进展或复发。倾向得分匹配（PSM）用于解释组间差异。结果：我们入组了62例患者；内镜辅助下经颅手术18例，经颅显微手术44例。内镜辅助下经颅显微手术组GTR率高于经颅显微手术组，术后住院时间短，肿瘤进展或复发率低于经颅显微手术组（GTR: 83.3%比52.3%,p= 0.046；术后住院时间：9.50 d[8.00, 13.75]比13.00 d [10.00, 17.25], p=0.023；肿瘤进展或复发率低于经颅显微手术组：11.1%比50%，p= 0.01）。经PSM后，内镜辅助手术组GTR率优于显微手术组（优势比（OR）： 7.51[1.37, 41.10]， 95%可信区间：1.37 ~ 41.10,p = 0.021）。结论：岩斜坡脑膜瘤仍然是一个手术挑战。内窥镜辅助显微手术增加了GTR率，提供了良好的可视化和对肿瘤的访问。因此，它可能被推荐作为PCM患者的一线治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

World neurosurgery CLINICAL NEUROLOGY-SURGERY

CiteScore

3.90

自引率

15.00%

发文量

1765

审稿时长

47 days

期刊介绍： World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal''s mission is to: -To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care. -To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide. -To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients. Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS