Zesheng Ying, Wei Yang, Nijia Zhang, Hailang Sun, Di Zhang, Baojin Shang, Jiashu Chen, Ming Ge
{"title":"侵犯脑脊液循环通路或邻近脑脊液循环通路的脑肿瘤儿科患者术后需要进行脑室腹腔分流术的风险因素。","authors":"Zesheng Ying, Wei Yang, Nijia Zhang, Hailang Sun, Di Zhang, Baojin Shang, Jiashu Chen, Ming Ge","doi":"10.3171/2024.1.PEDS23225","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Hydrocephalus is a common comorbidity of brain tumors in children that may persist following brain tumor resection. This study aimed to explore perioperative risk factors associated with postoperative ventriculoperitoneal shunt (VPS) placement for tumors located at or adjacent to the CSF circulation pathway.</p><p><strong>Methods: </strong>Patients aged 0-18 years with tumors invading or adjacent to the CSF circulation pathways who underwent brain tumor resection between October 2015 and September 2021 were included in this study. The outcome metric was whether patients underwent VPS placement within 6 months of tumor resection. Patients were followed up every 3-6 months after surgery. Demographic and perioperative imaging characteristics, clinical variables, and long-term treatments, including radiotherapy or chemotherapy, were included in the analysis.</p><p><strong>Results: </strong>Two hundred sixty-five children were included in this study. Of these patients, 38 (14.34%) underwent VPS placement within 6 months of tumor resection. One hundred thirty-two patients (49.81%) presented with preoperative hydrocephalus. Results from the multivariate analysis showed that medulloblastoma (OR 4.15, 95% CI 1.74-9.91, p = 0.001), lateral/third ventricle tumors (OR 4.07, 95% CI 1.33-12.30, p = 0.014), postoperative intraventricular hematoma (OR 3.36, 95% CI 1.53-7.38, p = 0.003), and presence of subdural hygroma in the nonoperated area within 48 hours after tumor resection (OR 2.78, 95% CI 1.15-6.74, p = 0.024) were independent risk factors for postoperative VPS placement.</p><p><strong>Conclusions: </strong>Postoperative lateral/third ventricle hematoma and subdural hygroma in the nonoperated area, anatomical location, and tumor histology may be potential risk factors for a postoperative VPS after brain tumor resection.</p>","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.1000,"publicationDate":"2024-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Risk factors for postoperative ventriculoperitoneal shunt requirement in pediatric patients with brain tumors invading or adjacent to CSF circulation pathways.\",\"authors\":\"Zesheng Ying, Wei Yang, Nijia Zhang, Hailang Sun, Di Zhang, Baojin Shang, Jiashu Chen, Ming Ge\",\"doi\":\"10.3171/2024.1.PEDS23225\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Hydrocephalus is a common comorbidity of brain tumors in children that may persist following brain tumor resection. This study aimed to explore perioperative risk factors associated with postoperative ventriculoperitoneal shunt (VPS) placement for tumors located at or adjacent to the CSF circulation pathway.</p><p><strong>Methods: </strong>Patients aged 0-18 years with tumors invading or adjacent to the CSF circulation pathways who underwent brain tumor resection between October 2015 and September 2021 were included in this study. The outcome metric was whether patients underwent VPS placement within 6 months of tumor resection. Patients were followed up every 3-6 months after surgery. Demographic and perioperative imaging characteristics, clinical variables, and long-term treatments, including radiotherapy or chemotherapy, were included in the analysis.</p><p><strong>Results: </strong>Two hundred sixty-five children were included in this study. Of these patients, 38 (14.34%) underwent VPS placement within 6 months of tumor resection. One hundred thirty-two patients (49.81%) presented with preoperative hydrocephalus. Results from the multivariate analysis showed that medulloblastoma (OR 4.15, 95% CI 1.74-9.91, p = 0.001), lateral/third ventricle tumors (OR 4.07, 95% CI 1.33-12.30, p = 0.014), postoperative intraventricular hematoma (OR 3.36, 95% CI 1.53-7.38, p = 0.003), and presence of subdural hygroma in the nonoperated area within 48 hours after tumor resection (OR 2.78, 95% CI 1.15-6.74, p = 0.024) were independent risk factors for postoperative VPS placement.</p><p><strong>Conclusions: </strong>Postoperative lateral/third ventricle hematoma and subdural hygroma in the nonoperated area, anatomical location, and tumor histology may be potential risk factors for a postoperative VPS after brain tumor resection.</p>\",\"PeriodicalId\":16549,\"journal\":{\"name\":\"Journal of neurosurgery. 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Pediatrics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3171/2024.1.PEDS23225","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/6/1 0:00:00","PubModel":"Print","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的:脑积水是儿童脑肿瘤的常见并发症,在脑肿瘤切除术后可能持续存在。本研究旨在探讨与位于或邻近 CSF 循环通路的肿瘤术后放置脑室腹腔分流术(VPS)相关的围手术期风险因素:本研究纳入了在2015年10月至2021年9月期间接受脑肿瘤切除术的0-18岁肿瘤侵犯或邻近CSF循环通路的患者。结果指标为患者是否在肿瘤切除术后 6 个月内接受了 VPS 置入术。术后每 3-6 个月对患者进行一次随访。人口统计学和围手术期影像学特征、临床变量和长期治疗(包括放疗或化疗)均纳入分析:本研究共纳入了 265 名儿童。其中,38 名患者(14.34%)在肿瘤切除术后 6 个月内接受了 VPS 置入术。132名患者(49.81%)术前出现脑积水。多变量分析结果显示,髓母细胞瘤(OR 4.15,95% CI 1.74-9.91,P = 0.001)、侧脑室/第三脑室肿瘤(OR 4.07,95% CI 1.33-12.30,P = 0.014)、术后脑室内血肿(OR 3.36,95% CI 1.53-7.38,p = 0.003)、肿瘤切除术后 48 小时内非手术区域出现硬膜下血肿(OR 2.78,95% CI 1.15-6.74,p = 0.024)是术后放置 VPS 的独立危险因素:结论:术后外侧/第三脑室血肿和非手术区域硬膜下血肿、解剖位置和肿瘤组织学可能是脑肿瘤切除术后放置VPS的潜在风险因素。
Risk factors for postoperative ventriculoperitoneal shunt requirement in pediatric patients with brain tumors invading or adjacent to CSF circulation pathways.
Objective: Hydrocephalus is a common comorbidity of brain tumors in children that may persist following brain tumor resection. This study aimed to explore perioperative risk factors associated with postoperative ventriculoperitoneal shunt (VPS) placement for tumors located at or adjacent to the CSF circulation pathway.
Methods: Patients aged 0-18 years with tumors invading or adjacent to the CSF circulation pathways who underwent brain tumor resection between October 2015 and September 2021 were included in this study. The outcome metric was whether patients underwent VPS placement within 6 months of tumor resection. Patients were followed up every 3-6 months after surgery. Demographic and perioperative imaging characteristics, clinical variables, and long-term treatments, including radiotherapy or chemotherapy, were included in the analysis.
Results: Two hundred sixty-five children were included in this study. Of these patients, 38 (14.34%) underwent VPS placement within 6 months of tumor resection. One hundred thirty-two patients (49.81%) presented with preoperative hydrocephalus. Results from the multivariate analysis showed that medulloblastoma (OR 4.15, 95% CI 1.74-9.91, p = 0.001), lateral/third ventricle tumors (OR 4.07, 95% CI 1.33-12.30, p = 0.014), postoperative intraventricular hematoma (OR 3.36, 95% CI 1.53-7.38, p = 0.003), and presence of subdural hygroma in the nonoperated area within 48 hours after tumor resection (OR 2.78, 95% CI 1.15-6.74, p = 0.024) were independent risk factors for postoperative VPS placement.
Conclusions: Postoperative lateral/third ventricle hematoma and subdural hygroma in the nonoperated area, anatomical location, and tumor histology may be potential risk factors for a postoperative VPS after brain tumor resection.