Comparative outcomes of transcranial craniotomy and endoscopic endonasal surgery for craniopharyngioma: a single-center retrospective cohort study - Summary - MDSpire
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Outcomes of Endoscopic Endonasal Surgery Versus Transcranial Craniotomy for Craniopharyngioma: A Retrospective Cohort Analysis from a Single Institution
To compare perioperative and follow-up outcomes, including extent of resection, length of stay, complications, endocrine outcomes, visual outcomes, postoperative radiotherapy, and recurrence/progression, between endoscopic endonasal approach (EEA) and transcranial craniotomy (TCA) for craniopharyngioma resection.
Approach:
Outcome Measures: Outcomes included extent of resection, length of stay, complications, axis-specific endocrine outcomes and replacement burden at 6 months, objective visual outcomes at 3 months, postoperative radiotherapy, and recurrence/progression at last follow-up.
Key Findings:
EEA achieved a higher gross total resection (GTR) rate (82.4% vs. 45.5%, p=0.002).
EEA resulted in a shorter hospital stay (16.19 ± 3.97 vs. 18.76 ± 4.23 days, p=0.019).
Improvement in headache/ICP-related symptoms was seen in 90.9% of EEA patients versus 76.5% of TCA patients (p=0.047).
Objective visual outcomes were better after EEA (BCVA: 0.30 vs. 0.42, p=0.041).
EEA had lower rates of electrolyte imbalance (17.6% vs. 42.4%, p=0.021) and transient diabetes insipidus (20.6% vs. 45.5%, p=0.028).
Recurrence/progression at last follow-up was lower in EEA patients (8.8% vs. 21.2%, p=0.047).
Interpretation:
EEA was associated with better outcomes in terms of GTR, hospitalization duration, and fewer complications compared to TCA.
Limitations:
The study is observational and unadjusted, making it susceptible to confounding by indication, which may affect the validity of the findings.
Results are based on a single-center experience, which may limit generalizability.
Conclusion:
EEA is associated with improved surgical outcomes for craniopharyngioma resection.
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