Intraventricular tumours: An individual patient data meta-analysis of conventional craniotomy versus minimally invasive techniques
6 affiliations
- 1Department of Neurosurgery, Queen's Hospital Romford, Barking, Havering and Redbridge University Hospitals NHS Trust, England, Essex, United Kingdom
- 2Barts and the London School of Medicine, Queen Mary University of London, England, London, United Kingdom
- 3School of Medicine and Population Health, The University of Sheffield, England, Sheffield, United Kingdom
- 4Imperial College Healthcare NHS Trust, England, London, United Kingdom
- 5King's College London GKT School of Medical Education, England, London, United Kingdom
- 6Department of Neurosurgery, King's College Hospital NHS Foundation Trust, England, London, United Kingdom
Abstract
Introduction: Intraventricular Tumours (IVTs) are rare intracranial lesions primarily treated with surgery. Surgical modalities include conventional craniotomy and minimally invasive surgery (MIS), such as tubular-assisted and endoscopic surgeries, with unclear benefits associated to each approach.
Research question: This systematic review compares gross total resection (GTR) rates, predictors of GTR, post-operative complications and requirement for permanent cerebrospinal fluid (CSF) diversion in conventional and MIS surgery.
Material and methods: Five databases were searched until November 2024, following the PRISMA guidelines. Studies reporting individual-level outcome data for IVT surgery were included.
Results: In total, 361 studies (1500 patients) were included. Most patients underwent conventional craniotomy (n = 1,243, 83%), followed by endoscopic (n = 223, 15%) and tubular-assisted surgery (n = 34, 2.3%). GTR was achieved in 67% (n = 830) of conventional cases compared to 46% (n = 103) of endoscopic and 76% (n = 26) of tubular-assisted approaches (p < 0.001 in univariate analysis; OR 0.38, 95% CrI 0.13–1.13 in multivariable analysis). Complications were reported in 37.8% (n = 567) of patients, among whom 48.9% (n = 277) experienced at least one complication, with most undergoing conventional craniotomy (n = 239). Permanent CSF diversion was required in 65% (n = 277) of patients and was significantly more likely in patients undergoing MIS in univariate analysis. The multivariable analysis revealed that only pre-operative hydrocephalus (OR 8.92, 95% CrI 2.04-38.93) was significantly associated with permanent diversion, while surgical approach was not.
Discussion and conclusion: There is a significant unbalance in the amount of cases reported with conventional craniotomy and MIS supporting the early days of MIS approaches for IVTs. Conventional and MIS approaches for IVTs achieve comparable rates of GTR and permanent CSF diversion.
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BibTeX
@article{mirza2026intraventricular,
title = {{Intraventricular tumours: An individual patient data meta-analysis of conventional craniotomy versus minimally invasive techniques}},
author = {Asfand Baig Mirza and Ariadni Georgiannakis and Sami Rashed and Joe Priestley and Feras Fayez and Pak Yin Lam and Amisha Vastani and Natalie Simon and Soha Zahid and Yasir A. Chowdhury and Prajwal Ghimire and Keyoumars Ashkan and Francesco Vergani and Ranjeev Bhangoo and Bassel Zebian and Sanjeev Bassi and Jonathan Pollock and Cristina Bleil and Jose-Pedro Lavrador},
journal = {Brain \& Spine},
year = {2026},
month = oct,
doi = {10.1016/j.bas.2026.107467},
url = {https://doi.org/10.1016/j.bas.2026.107467},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Intraventricular tumours: An individual patient data meta-analysis of conventional craniotomy versus minimally invasive techniques
AU - Asfand Baig Mirza
AU - Ariadni Georgiannakis
AU - Sami Rashed
AU - Joe Priestley
AU - Feras Fayez
AU - Pak Yin Lam
AU - Amisha Vastani
AU - Natalie Simon
AU - Soha Zahid
AU - Yasir A. Chowdhury
AU - Prajwal Ghimire
AU - Keyoumars Ashkan
AU - Francesco Vergani
AU - Ranjeev Bhangoo
AU - Bassel Zebian
AU - Sanjeev Bassi
AU - Jonathan Pollock
AU - Cristina Bleil
AU - Jose-Pedro Lavrador
PY - 2026
DA - 2026/10/06
JO - Brain & Spine
DO - 10.1016/j.bas.2026.107467
UR - https://doi.org/10.1016/j.bas.2026.107467
AB - Introduction: Intraventricular Tumours (IVTs) are rare intracranial lesions primarily treated with surgery. Surgical modalities include conventional craniotomy and minimally invasive surgery (MIS), such as tubular-assisted and endoscopic surgeries, with unclear benefits associated to each approach. Research question: This systematic review compares gross total resection (GTR) rates, predictors of GTR, post-operative complications and requirement for permanent cerebrospinal fluid (CSF) diversion in conventional and MIS surgery. Material and methods: Five databases were searched until November 2024, following the PRISMA guidelines. Studies reporting individual-level outcome data for IVT surgery were included. Results: In total, 361 studies (1500 patients) were included. Most patients underwent conventional craniotomy (n = 1,243, 83%), followed by endoscopic (n = 223, 15%) and tubular-assisted surgery (n = 34, 2.3%). GTR was achieved in 67% (n = 830) of conventional cases compared to 46% (n = 103) of endoscopic and 76% (n = 26) of tubular-assisted approaches (p < 0.001 in univariate analysis; OR 0.38, 95% CrI 0.13–1.13 in multivariable analysis). Complications were reported in 37.8% (n = 567) of patients, among whom 48.9% (n = 277) experienced at least one complication, with most undergoing conventional craniotomy (n = 239). Permanent CSF diversion was required in 65% (n = 277) of patients and was significantly more likely in patients undergoing MIS in univariate analysis. The multivariable analysis revealed that only pre-operative hydrocephalus (OR 8.92, 95% CrI 2.04-38.93) was significantly associated with permanent diversion, while surgical approach was not. Discussion and conclusion: There is a significant unbalance in the amount of cases reported with conventional craniotomy and MIS supporting the early days of MIS approaches for IVTs. Conventional and MIS approaches for IVTs achieve comparable rates of GTR and permanent CSF diversion.
SN - 2772-5294
ER -