Clinical Results and Quality of Life After Transcortical Versus Transcallosal Resection of Adult Lateral and Third Ventricle Lesions: Long-Term Outcome

World Neurosurg. 2023 Nov:179:e194-e200. doi: 10.1016/j.wneu.2023.08.050. Epub 2023 Aug 21.

Abstract

Background: Resection of intraventricular tumors can be achieved using 2 main operative approaches: transcallosal or transcortical. This study aims to describe preoperative and postoperative factors as well as quality of life (QoL) based on long-term results in these patients.

Methods: Patients underwent surgery of primary intraventricular lesions between 2007 and 2020 via a transcortical (group A) or transcallosal (group B) route. The main clinical parameters were completeness of resection, overall survival, surgical complications, postoperative neurologic deficits, and seizure rates. QoL was assessed using a modified questionnaire Short-Form 36 inventory.

Results: Forty patients (19 women and 21 men) met the inclusion criteria. Group A consisted of 26 patients (12 women and 14 men; median age 45.5 years ± 16.7 standard deviation) and had lower preoperative tumor volume (confounder) compared with group B (7 women and 7 men; age 50.0 ± 17.4 years). Gross total resection was achieved in 65% in group A and 71% in group B. Follow-up was 7.8 ± 3.9 years. New seizures/permanent neurologic deficits occurred in 27%/15% (group A) and 29%/29% (group B) and surgical complications in 23% of patients. Group B had a higher degree of memory impairment (21%) compared with group A (10%). QoL impairment was present in both groups mainly regarding physical role function and mental health index.

Conclusions: Keeping in mind the limitations, transcallosal surgery was associated with a higher probability of neurologic deficits and memory impairment in our series. However, it had fewer surgical complications with similar gross total resection and seizure rates.

Keywords: Functional outcome; Morbidity; Quality of life; Surgical approach; Ventricle tumor.

MeSH terms

  • Adult
  • Aged
  • Cerebral Ventricle Neoplasms* / pathology
  • Cerebral Ventricle Neoplasms* / surgery
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neurosurgical Procedures / methods
  • Quality of Life
  • Retrospective Studies
  • Seizures / etiology
  • Seizures / surgery
  • Third Ventricle* / surgery
  • Treatment Outcome