医学
颅咽管瘤
内分泌系统
外科
优势比
回顾性队列研究
Ommaya水库
激素
内科学
化疗
作者
Laura-Nanna Lohkamp,Abhaya V. Kulkarni,James M. Drake,James T. Rutka,Peter B. Dirks,Michael D. Taylor,George M. Ibrahim,Jill Hamilton,Ute Bartels
标识
DOI:10.1007/s11060-022-04099-0
摘要
Children with craniopharyngiomas (CP) can experience significant morbidities caused by extensive surgery and/or radiation. Ommaya reservoir insertion (ORI) into cystic CP represents a minimally invasive approach allowing immediate decompression and aims to avoid additional injuries. The purpose of this study was to determine the surgical outcome and relevance of upfront ORI (± intracystic treatment) for preservation of endocrine function. We performed a retrospective chart review of children with CP treated at the Hospital for Sick Children between 01/01/2000 and 15/01/2020. Endocrine function was reviewed at the time of initial surgery and throughout follow-up. New endocrinological deficits related to the index procedure were defined as immediate failure (IF), whereas postoperative duration of endocrinological stability (ES) was analyzed using the Kaplan-Meier method. The rate of IF and ES was compared between the treatment groups. Seventy-nine patients were included and had a median age of 8.3 years (range 2.1–18.0 years); 31 were males. Fifty-three patients with upfront surgical treatment, including 29 ORI and 24 gross total or partial resections had sufficient endocrinological follow-up data. Endocrine dysfunction occurring immediately after the index procedure (IF) was observed in 15 patients (62.5%) in the resection group compared to two patients (6.8%) in the ORI group, odds ratio: 0.05 (CI: 0.01–0.26, p < 0.0001). Excluding those with immediate endocrinological deficits, mean ES after ORI was 19.4 months (CI: 11.6–34.2), compared to 13.4 months (CI:10.6-NA) after surgical resection. Endocrine function was preserved in patients with upfront ORI (± intracystic treatment), which was confirmed as a minimally invasive procedure with an overall low morbidity profile.
科研通智能强力驱动
Strongly Powered by AbleSci AI