Systematic review of pineal cysts surgery in pediatric patients

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Choque-Velasquez , J , Colasanti , R , Baluszek , S , Resendiz-Nieves , J , Muhammad , S , Ludtka , C & Hernesniemi , J 2020 , ' Systematic review of pineal cysts surgery in pediatric patients ' , Child's Nervous System , vol. 36 , no. 12 , pp. 2927–2938 .

Title: Systematic review of pineal cysts surgery in pediatric patients
Author: Choque-Velasquez, Joham; Colasanti, Roberto; Baluszek, Szymon; Resendiz-Nieves, Julio; Muhammad, Sajjad; Ludtka, Christopher; Hernesniemi, Juha
Contributor organization: Clinicum
HUS Neurocenter
Neurokirurgian yksikkö
University of Helsinki
Helsinki University Hospital Area
Department of Neurosciences
Date: 2020-12
Language: eng
Number of pages: 12
Belongs to series: Child's Nervous System
ISSN: 0256-7040
Abstract: Introduction We present a consecutive case series and a systematic review of surgically treated pediatric PCs. We hypothesized that the symptomatic PC is a progressive disease with hydrocephalus at its last stage. We also propose that PC microsurgery is associated with better postoperative outcomes compared to other treatments. Methods The systematic review was conducted in PubMed and Scopus. No clinical study on pediatric PC patients was available. We performed a comprehensive evaluation of the available individual patient data of 43 (22 case reports and 21 observational series) articles. Results The review included 109 patients (72% females). Ten-year-old or younger patients harbored smaller PC sizes compared to older patients (p<0.01). The pediatric PCs operated on appeared to represent a progressive disease, which started with unspecific symptoms with a mean cyst diameter of 14.5 mm, and progressed to visual impairment with a mean cyst diameter of 17.8 mm, and hydrocephalus with a mean cyst diameter of 23.5 mm in the final stages of disease (p<0.001). Additionally, 96% of patients saw an improvement in their symptoms or became asymptomatic after surgery. PC microsurgery linked with superior gross total resection compared to endoscopic and stereotactic procedures (p<0.001). Conclusions Surgically treated pediatric PCs appear to behave as a progressive disease, which starts with cyst diameters of approximately 15 mm and develops with acute or progressive hydrocephalus at the final stage. PC microneurosurgery appears to be associated with a more complete surgical resection compared to other procedures.
Subject: Microneurosurgery
Pineal cysts
Sitting position
Supracerebellar infratentorial approach
3112 Neurosciences
3124 Neurology and psychiatry
3123 Gynaecology and paediatrics
3126 Surgery, anesthesiology, intensive care, radiology
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion

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