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Predictive factors for persistent postoperative hydrocephalus in children undergoing surgical resection of periventricular tumors
OBJECTIVE: The aim of this study is to identify the factors predicting persistent hydrocephalus after periventricular tumor resection in children and assess the need and efficacy of perioperative cerebrospinal fluid (CSF) intervention. METHODS: We performed a retrospective analysis of pediatric pati...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10352985/ https://www.ncbi.nlm.nih.gov/pubmed/37470001 http://dx.doi.org/10.3389/fneur.2023.1136840 |
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author | Chen, Zitao Zhou, Ming Wen, Huantao Wang, Qiang Guan, Jianwei Zhang, Yuan Zhang, Wangming |
author_facet | Chen, Zitao Zhou, Ming Wen, Huantao Wang, Qiang Guan, Jianwei Zhang, Yuan Zhang, Wangming |
author_sort | Chen, Zitao |
collection | PubMed |
description | OBJECTIVE: The aim of this study is to identify the factors predicting persistent hydrocephalus after periventricular tumor resection in children and assess the need and efficacy of perioperative cerebrospinal fluid (CSF) intervention. METHODS: We performed a retrospective analysis of pediatric patients who underwent resection surgery of a periventricular tumor between March 2012 and July 2021 at the Department of Neurosurgery in Zhujiang Hospital of South Medical University. Demographic, radiographic, perioperative, and dispositional data were analyzed using univariate and multivariate models. RESULTS: A total of 117 patients were enrolled in our study. Incidence of postoperative persistent hydrocephalus varied with tumor pathology (p = 0.041), tumor location (p = 0.046), surgical approach (p = 0.013), extension of resection (p = 0.043), tumor volume (p = 0.041), preoperative Evan's index (p = 0.002), and preoperative CSF diversion (p = 0.024). On logistic regression, posterior median approach (OR = 5.315), partial resection (OR = 20.984), volume > 90cm(3) (OR = 5.768), and no preoperative CSF diversion (OR = 3.661) were independent predictors of postoperative persistent hydrocephalus. Preoperative Evan's index is significantly correlated with tumor volume (p = 0.019). Meanwhile, the need for preoperative CSF drainage in patients in this cohort was significantly correlated with tumor location (p = 0.019). CONCLUSION: Tumor pathology, location, surgical approach, the extension of resection, tumor volume, preoperative Evan's index, and preoperative CSF diversion were considered to be predictive factors for postoperative persistent hydrocephalus. Notably, posterior median approach, partial resection, and tumor volume > 90cm(3), without preoperative CSF diversion, were identified as independent risk factors for persistent postoperative hydrocephalus. Preoperative identification of children at risk of developing persistent postoperative hydrocephalus would avoid delays in planning the cerebrospinal fluid diversion. Active and effective preoperative hydrocephalus intervention in children with periventricular tumors is beneficial to reduce the incidence of persistent hydrocephalus and ventriculoperitoneal shunt surgery after resection. |
format | Online Article Text |
id | pubmed-10352985 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-103529852023-07-19 Predictive factors for persistent postoperative hydrocephalus in children undergoing surgical resection of periventricular tumors Chen, Zitao Zhou, Ming Wen, Huantao Wang, Qiang Guan, Jianwei Zhang, Yuan Zhang, Wangming Front Neurol Neurology OBJECTIVE: The aim of this study is to identify the factors predicting persistent hydrocephalus after periventricular tumor resection in children and assess the need and efficacy of perioperative cerebrospinal fluid (CSF) intervention. METHODS: We performed a retrospective analysis of pediatric patients who underwent resection surgery of a periventricular tumor between March 2012 and July 2021 at the Department of Neurosurgery in Zhujiang Hospital of South Medical University. Demographic, radiographic, perioperative, and dispositional data were analyzed using univariate and multivariate models. RESULTS: A total of 117 patients were enrolled in our study. Incidence of postoperative persistent hydrocephalus varied with tumor pathology (p = 0.041), tumor location (p = 0.046), surgical approach (p = 0.013), extension of resection (p = 0.043), tumor volume (p = 0.041), preoperative Evan's index (p = 0.002), and preoperative CSF diversion (p = 0.024). On logistic regression, posterior median approach (OR = 5.315), partial resection (OR = 20.984), volume > 90cm(3) (OR = 5.768), and no preoperative CSF diversion (OR = 3.661) were independent predictors of postoperative persistent hydrocephalus. Preoperative Evan's index is significantly correlated with tumor volume (p = 0.019). Meanwhile, the need for preoperative CSF drainage in patients in this cohort was significantly correlated with tumor location (p = 0.019). CONCLUSION: Tumor pathology, location, surgical approach, the extension of resection, tumor volume, preoperative Evan's index, and preoperative CSF diversion were considered to be predictive factors for postoperative persistent hydrocephalus. Notably, posterior median approach, partial resection, and tumor volume > 90cm(3), without preoperative CSF diversion, were identified as independent risk factors for persistent postoperative hydrocephalus. Preoperative identification of children at risk of developing persistent postoperative hydrocephalus would avoid delays in planning the cerebrospinal fluid diversion. Active and effective preoperative hydrocephalus intervention in children with periventricular tumors is beneficial to reduce the incidence of persistent hydrocephalus and ventriculoperitoneal shunt surgery after resection. Frontiers Media S.A. 2023-07-04 /pmc/articles/PMC10352985/ /pubmed/37470001 http://dx.doi.org/10.3389/fneur.2023.1136840 Text en Copyright © 2023 Chen, Zhou, Wen, Wang, Guan, Zhang and Zhang. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Neurology Chen, Zitao Zhou, Ming Wen, Huantao Wang, Qiang Guan, Jianwei Zhang, Yuan Zhang, Wangming Predictive factors for persistent postoperative hydrocephalus in children undergoing surgical resection of periventricular tumors |
title | Predictive factors for persistent postoperative hydrocephalus in children undergoing surgical resection of periventricular tumors |
title_full | Predictive factors for persistent postoperative hydrocephalus in children undergoing surgical resection of periventricular tumors |
title_fullStr | Predictive factors for persistent postoperative hydrocephalus in children undergoing surgical resection of periventricular tumors |
title_full_unstemmed | Predictive factors for persistent postoperative hydrocephalus in children undergoing surgical resection of periventricular tumors |
title_short | Predictive factors for persistent postoperative hydrocephalus in children undergoing surgical resection of periventricular tumors |
title_sort | predictive factors for persistent postoperative hydrocephalus in children undergoing surgical resection of periventricular tumors |
topic | Neurology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10352985/ https://www.ncbi.nlm.nih.gov/pubmed/37470001 http://dx.doi.org/10.3389/fneur.2023.1136840 |
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