Endoscopic versus stereotactic procedure for pineal tumour biopsies: focus on overall efficacy rate.

Endoscopic versus stereotactic procedure for pineal tumour biopsies: focus on overall efficacy rate.

World Neurosurg. 2016 Apr 6;

Authors: Balossier A, Blond S, Reyns N

Abstract
OBJECTIVE: The management of pineal region tumours highly depends on the histological subtypes. Two minimally invasive techniques are available for this issue: endoscopic intraventricular biopsies and stereotactic biopsies. The recent Southampton's and Lille's series are the largest endoscopic and stereotactic series of pineal region tumours reporting both diagnosis rate and accuracy rate, respectively; we elaborated on these results in the light of other recent studies.
METHODS: We compared the Southampton's endoscopic series to the Lille's series reflecting our 25-year experience of stereotactic biopsies, and the metadata of the literature for both approaches, as reported in the Report 2013 of the French-Speaking Society of Neurosurgery on the tumours of the pineal region.
RESULTS: The results of the Southampton's series match the endoscopic literature, in particular regarding the diagnosis rate (81.2%) or the perioperative morbidity (25.0%), and provides rarely-reported accuracy rate (78.6%), giving access to the overall efficacy rate (63.8%). The results of the Lille's series match the stereotactic literature and show better results than endoscopic biopsies concerning the diagnosis rate (98.9%), accuracy rate (100%), resulting overall efficacy rate (98.9%), and perioperative morbidity (6.4%).
CONCLUSION: The Southampton's and Lille's series provide a unique opportunity to compare the overall efficacy rates of endoscopic and stereotactic biopsies, respectively. Until today the stereotactic approach remains safer and more effective for biopsies of pineal region tumours. In order to improve the safety and reliability of endoscopic biopsies, various methods have to be evaluated: alternative burr-hole strategies, use of neuronavigation, and combination of flexible and rigid endoscopes.

PMID: 27060509 [PubMed - as supplied by publisher]

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