NDLI: Endoscopic endonasal transsphenoidal approach improves endocrine function and surgical outcome in primary craniopharyngioma resection: a systematic review and meta-analysis

Content Provider	Springer Nature : BioMed Central
Author	Li, Shuang Ye, Youfan Nie, Chuansheng Huang, Xing Yan, Kaixuan Zhang, Fangcheng Jiang, Xiaobing Wang, Haijun
Abstract	Background Craniopharyngiomas (CPs) are generally derived from the craniopharyngeal duct epithelium, accounting for 38% and 24.5% of mortality in pediatric and adult patients, respectively. At present, the widespread application of the endoscopic endonasal transsphenoidal approach (EEA) has led to controversy between the traditional microscopic transcranial approach (TCA) and EEA in relation to the surgical management of CPs. Object and method We performed a systematic review and meta-analysis comparing the complications, surgical outcomes, and endocrine functions of patients with CPs to provide evidence-based decision-making in their surgical management. Result Overall, 11 observational studies with 12,212 participants were included in the meta-analysis, in which five of them only included an adult population, three of them only included a child population, and the other three studies included a mixed population (adult and child). In pediatric patients, the EEA achieved a higher gross total resection (GTR) rate (odds ratio (OR) = 5.25, 95%CI: 1.21–22.74), lower recurrence rate (OR = 0.54, 95%CI: 0.31–0.94, p = 0.030), and less hypopituitarism (OR = 0.34, 95%CI: 0.12–0.97, p = 0.043). In adult patients, EEA significantly improved mortality (OR = 0.09, 95%CI: 0.06–0.15, p < 0.001) and visual outcomes (visual improvement: OR = 3.42, 95%CI: 1.24–9.40, p = 0.017; visual deficit: OR = 0.30, 95%CI: 0.26–0.35) with decreases in postoperative stroke (OR = 0.58, 95%CI: 0.51–0.66, p < 0.001), hydrocephalus, and infections (OR = 0.32, 95%CI: 0.24–0.42, p < 0.001). Conclusion Compared with the traditional TCA in primary CP resection, the development and wide application of EEA optimistically decreased the recurrence rate of CP, alleviated hypopituitarism with improvement in the GTR rate of pediatric patients, and significantly improved the visual outcomes, hydrocephalus, postoperative stroke, survival, and infection rates of the patients. Therefore, EEA is an optimal approach for primary CP resection.
Related Links	https://wjso.biomedcentral.com/counter/pdf/10.1186/s12957-024-03411-8.pdf
Ending Page	14
Page Count	14
Starting Page	1
File Format	HTM / HTML
ISSN	14777819
DOI	10.1186/s12957-024-03411-8
Journal	World Journal of Surgical Oncology
Issue Number	1
Volume Number	22
Language	English
Publisher	BioMed Central
Publisher Date	2024-05-24
Access Restriction	Open
Subject Keyword	Surgical Oncology Meta-analysis Microscopic transcranial approach Endoscopic endonasal transsphenoidal approach Craniopharyngiomas Neurosurgery
Content Type	Text
Resource Type	Review
Subject	Oncology Surgery
Journal Impact Factor	2.5/2023
5-Year Journal Impact Factor	2.8/2023

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