Evaluating the Impact of Tubular Retractors in Glioma Surgery: A Systematic Review and Meta-analysis
Document Type
Article
Publication Title
Clinical Neurology and Neurosurgery
Abstract
Background: Achieving safe, maximal tumor resection in gliomas can be challenging due to the tumor's intricate relationship with surrounding structures. Tubular retractors offer a minimally invasive approach, preserving functional pathways and reducing complications. To assess their efficacy and safety, we conducted a systematic review and meta-analysis.
Methods: A search across databases identified 26 studies meeting inclusion criteria, encompassing 106 patients with various glioma types and tumor locations.
Results: Among 26 eligible studies, 15 provided sufficient data on 106 patients (median age: 50.5 years). Glioblastoma multiforme constituted 52.4 % of tumors, followed by IDH-mutant astrocytomas at 31.0 %. Tumor locations varied, with intraventricular and thalamic involvement in 16.3 % (16/98) of cases, followed by temporal (12.2 %), frontal and occipital (each 8.16 %), basal ganglia (8.16 %), parietal (7.14 %), optic pathway (2.04 %), and caudate nucleus (1.02 %) involvement. VyCor and Brainpath retractors were most used (22.6 % and 21.7 %, respectively). Tubular retractors were often combined with the exoscope (35.9 %). Gross total resection (GTR) was achieved in 69.4 % of cases, near-total resection (NTR) in 5.1 %, and subtotal resection/partial resection (STR/PR) in 25.5 %. Mean extent of resection (EOR) significantly differed between GTR and STR/NTR/PR groups (p
Conclusion: Tubular retractors are a valuable intraoperative adjunct and component of the surgical armamentarium for glioma surgery allowing bimanual operative techniques to manage hemostasis directly with excellent surgical outcomes and an acceptable complication profile.
DOI
10.1016/j.clineuro.2024.108461
Publication Date
8-8-2024
Keywords
Adjunctive Therapy, Extent of Resection, Glioma, Tubular Retractor, Tumor
ISSN
1872-6968
Recommended Citation
Taylor Z, Gupta A, Mehta NH, Pishva S, Gupta N, Barrington NM, Kashanian A, D'Amico RS. Evaluating the Impact of Tubular Retractors in Glioma Surgery: A Systematic Review and Meta-analysis. Clinical Neurology and Neurosurgery. 2024; . doi: 10.1016/j.clineuro.2024.108461.
