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Risk for hydrocephalus, hygroma, and tumor dissemination after ventricular opening during resection of supratentorial neoplasms in children

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Abstract

Purpose

The possibility that ventricular opening generates postoperative complications after surgical tumor treatment often restricts the degree of tumor resection. This study aims to determine whether the ventricular opening is associated with more complications in surgeries for resectioning supratentorial intra-axial brain tumors in the pediatric population.

Methods

A retrospective review analysis was performed of patients treated at IOP/GRAACC between 2002 and 2020 under 19 years of age and underwent surgery for supratentorial intra-axial primary brain tumor resection. Data were collected from 43 patients.

Results

Glial tumor was more common than non-glial (65% vs. 35%, p = 0.09). The ventricular opening was not related to neoplastic spreads to the neuroaxis (6% vs. 0, p > 0.9) or leptomeningeal (3% vs. 0, p > 0.9). Of the patients whose ventricle was opened, 10% developed hydrocephalus requiring treatment, while none of the patients in the group without ventricular opening developed hydrocephalus (p = 0.5). There was also no statistical difference regarding ventriculitis. Postoperative subdural hygroma formation correlated with the ventricular opening (43% vs. 0, p = 0.003). The survival at 1, 5, and 10 years of cases with the ventricular opening was 93.2%, 89.7%, and 75.7%, respectively, while in cases without ventricular opening, it was 100%, 83%, and 83%, respectively, respectively, with no statistical difference between the mortality curves.

Conclusion

Our study demonstrated that ventricular violation was not associated with the occurrence of significant complications. It was related to the formation of subdural hygroma, which did not require additional treatment.

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Acknowledgements

We thank Nurse Daniela Barbosa de Almeida for her ongoing and loving care work with the patients in this study and for the support and assistance to the entire medical team in managing these patients.

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Authors and Affiliations

  1. Department of Neurology and Neurosurgery, Universidade Federal de Sao Paulo, Sao Paulo, Brazil

    Marcos Devanir Silva da Costa, Talita Helena Martins Sarti, Herison Vaz, Patricia Alessandra Dastoli, Jardel Mendonça Nicácio & Sergio Cavalheiro

  2. Division of Neurosurgery, Instituto de Oncologia Pediatrica (IOP/GRAACC), Sao Paulo, Brazil

    Marcos Devanir Silva da Costa, Herison Vaz, Patricia Alessandra Dastoli, Jardel Mendonça Nicácio & Sergio Cavalheiro

  3. Division of Radiology, Instituto de Oncologia Pediatrica (IOP/GRAACC), Sao Paulo, Brazil

    Frederico Adolfo Benevides Silva

  4. Division of Neuro-Oncology, Instituto de Oncologia Pediatrica (IOP/GRAACC), Sao Paulo, Brazil

    Andrea Maria Cappellano & Nasjla Saba Silva

Authors
  1. Marcos Devanir Silva da Costa
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  2. Talita Helena Martins Sarti
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  3. Herison Vaz
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  4. Patricia Alessandra Dastoli
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  5. Jardel Mendonça Nicácio
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  6. Frederico Adolfo Benevides Silva
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  7. Andrea Maria Cappellano
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  8. Nasjla Saba Silva
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  9. Sergio Cavalheiro
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Contributions

Conception of the study: Marcos Devanir Silva da Costa and Sérgio Cavalheiro. Data collection: Talita Helena Martins Sarti, Herison Vaz, and Frederico Adolfo Benevides Silva. Data analysis and interpretation: Marcos Devanir Silva da Costa, Patrícia Alessandra Dastoli, and Jardel Mendonça Nicácio. Drafting the article: Talita Helena Martins Sarti. Critical revision of the article: Nasjla Saba Silva, Andrea Maria Cappellano, and Sérgio Cavalheiro. Final approval of the version to be published: Marcos Devanir Silva da Costa and Sérgio Cavalheiro.

Corresponding author

Correspondence to Talita Helena Martins Sarti.

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Ethics approval and consent to participate 

The study was approved by the Research Ethics Committee of the Universidade Federal de São Paulo, São Paulo, Brazil. Informed consent was obtained from the guardians. 

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Informed consent was obtained from the guardians for publication.

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There are no conflicts of interest to declare.

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da Costa, M.D.S., Sarti, T.H.M., Vaz, H. et al. Risk for hydrocephalus, hygroma, and tumor dissemination after ventricular opening during resection of supratentorial neoplasms in children. Childs Nerv Syst 39, 1881–1887 (2023). https://doi.org/10.1007/s00381-023-05861-z

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  • DOI: https://doi.org/10.1007/s00381-023-05861-z

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