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<p>Endoscopic procedures, especially ventriculocystostomy (VC) and ventriculocystocisternostomy (VCC), are preferred treatments for suprasellar arachnoid cysts (SACs). Yet, results from current studies on their effects are varied. This study offers a comprehensive systematic review on surgical and clinical outcomes after VC and VCC and the risk of reoperation is compared by a meta-analysis.&#xa0;We conducted a literature search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify surgical articles evaluating endoscopic treatment modalities for SAC using PubMed/Medline and Embase. The primary outcome was the risk of reoperation with a subgroup analysis among infants &lt; 1 years of age. Postoperative complications were described to the extend they were reported in the literature. The risk of bias was assessed using the Newcastle-Ottawa scoring system. The meta-analysis was performed using RevMan 5.0 to compare the reoperation rates for VC and VCC as a risk ratio from a Forest plot with 95% confidence intervals in a fixed-effects model. Publication bias was assessed visually using a funnel plot.&#xa0;Nineteen observational studies were eligible for inclusion, comprising 94 patients who underwent VCC and 427 patients who underwent VC. Patients who underwent VCC had a significantly lower risk of reoperation of 0.33 (95% CI 0.17–0.65; <i>p</i> &lt; 0.002). However, the risk of postoperative complications was considerable for both VCC (16.7%) and VC (12.7%), yet not significantly different (<i>p</i> = 0.915). Within the subgroup of infants age &lt; 1 year, the risk of reoperation was significantly higher (29.4%) compared to older children (5.7%) (95% CI 1.96–42.07; <i>p</i> &lt; 0.002).&#xa0;The results support VCC as an effective and long-lasting treatment for symptomatic SACs with significantly lower reoperation rates, compared to VC.</p>

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Endoscopic treatment methods of suprasellar arachnoid cysts in children: A systematic review and meta-analysis

  • 期刊论文

  • 发表日期：

    2025年11月25日

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  • Frederikke Guldberg,
  • Agnes Tving Stauning,
  • Carl Christian Larsen,
  • Marianne Juhler,
  • Carsten Reidies Bjarkam,
  • Tina Nørgaard Munch

摘要

Endoscopic procedures, especially ventriculocystostomy (VC) and ventriculocystocisternostomy (VCC), are preferred treatments for suprasellar arachnoid cysts (SACs). Yet, results from current studies on their effects are varied. This study offers a comprehensive systematic review on surgical and clinical outcomes after VC and VCC and the risk of reoperation is compared by a meta-analysis. We conducted a literature search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify surgical articles evaluating endoscopic treatment modalities for SAC using PubMed/Medline and Embase. The primary outcome was the risk of reoperation with a subgroup analysis among infants < 1 years of age. Postoperative complications were described to the extend they were reported in the literature. The risk of bias was assessed using the Newcastle-Ottawa scoring system. The meta-analysis was performed using RevMan 5.0 to compare the reoperation rates for VC and VCC as a risk ratio from a Forest plot with 95% confidence intervals in a fixed-effects model. Publication bias was assessed visually using a funnel plot. Nineteen observational studies were eligible for inclusion, comprising 94 patients who underwent VCC and 427 patients who underwent VC. Patients who underwent VCC had a significantly lower risk of reoperation of 0.33 (95% CI 0.17–0.65; p < 0.002). However, the risk of postoperative complications was considerable for both VCC (16.7%) and VC (12.7%), yet not significantly different (p = 0.915). Within the subgroup of infants age < 1 year, the risk of reoperation was significantly higher (29.4%) compared to older children (5.7%) (95% CI 1.96–42.07; p < 0.002). The results support VCC as an effective and long-lasting treatment for symptomatic SACs with significantly lower reoperation rates, compared to VC.