Abstract：
Pediatric brainstem lesions are diagnoses that require tissue sampling to advance our understanding of them and their management. Frameless, robot-assisted biopsy of these lesions has emerged as a novel, viable biopsy approach. Correspondingly, the aim of this study was to quantitively and qualitatively summarize the contemporary literature regarding the likelihood of achieving tumor diagnosis and experiencing any postoperative complications.
Searches of 7 electronic databases from inception to September 2022 were conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Articles were screened against prespecified criteria. Outcomes were pooled by random-effects meta-analyses of proportions where possible.
A total of 8 cohort studies satisfied all criteria. They described 99 pediatric patients with brainstem lesions in whom frameless, robot-assisted biopsy was involved in their work-up. There were 62 (63%) male and 37 (37%) female patients with a median age of 9 years at time of biopsy. Overall, all patients had sufficient tissue obtained by initial biopsy for evaluation. Pooled estimate of achieving tumor diagnosis was 100% (95% confidence interval [CI] 97%-100%) across all studies with a high degree of certainty. Across all studies, there were no cases of procedure-related mortality. The pooled estimates of transient and permanent complications after biopsy were 10% (95% CI 4%-19%) and 0% (95% CI 0%-2%), respectively, of very low and low degrees of certainty each.
The contemporary metadata demonstrates the frameless, robot-assisted biopsy of pediatric brainstem lesions is both effective and safe when performed in an experienced setting. Further research is needed to augment robot and automated technologies into workup algorithms.
Searches of 7 electronic databases from inception to September 2022 were conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Articles were screened against prespecified criteria. Outcomes were pooled by random-effects meta-analyses of proportions where possible.
A total of 8 cohort studies satisfied all criteria. They described 99 pediatric patients with brainstem lesions in whom frameless, robot-assisted biopsy was involved in their work-up. There were 62 (63%) male and 37 (37%) female patients with a median age of 9 years at time of biopsy. Overall, all patients had sufficient tissue obtained by initial biopsy for evaluation. Pooled estimate of achieving tumor diagnosis was 100% (95% confidence interval [CI] 97%-100%) across all studies with a high degree of certainty. Across all studies, there were no cases of procedure-related mortality. The pooled estimates of transient and permanent complications after biopsy were 10% (95% CI 4%-19%) and 0% (95% CI 0%-2%), respectively, of very low and low degrees of certainty each.
The contemporary metadata demonstrates the frameless, robot-assisted biopsy of pediatric brainstem lesions is both effective and safe when performed in an experienced setting. Further research is needed to augment robot and automated technologies into workup algorithms.
摘要：
背景：小儿脑干病变是需要组织取样的诊断，以增进我们对它们及其管理的理解。无框,这些病变的机器人辅助活检已经成为一种新的，可行的活检方法。相应地,本研究的目的是定量和定性地总结有关实现肿瘤诊断和经历任何术后并发症的可能性的当代文献.
方法：根据系统评价和荟萃分析指南的首选报告项目，从开始到2022年9月对7个电子数据库进行了搜索。根据预先指定的标准筛选文章。结果在可能的情况下通过随机效应比例荟萃分析进行汇总。
结果：共有8项队列研究满足所有标准。他们描述了99名患有脑干病变的儿科患者，机器人辅助活检参与了他们的检查.活检时，男性患者62例（63％），女性患者37例（37％），中位年龄为9岁。总的来说,所有患者通过初次活检获得了足够的组织用于评估.在所有研究中，实现肿瘤诊断的汇总估计为100％（95％置信区间[CI]97％-100％），具有高度的确定性。在所有研究中，无手术相关死亡病例.活检后暂时性和永久性并发症的汇总估计值为10%（95%CI4%-19%）和0%（95%CI0%-2%），分别,每个人的确定性都很低和很低。
结论：当代元数据展示了无框架，在有经验的环境中进行小儿脑干病变的机器人辅助活检既有效又安全.需要进一步的研究来将机器人和自动化技术扩展到工作算法中。
方法：根据系统评价和荟萃分析指南的首选报告项目，从开始到2022年9月对7个电子数据库进行了搜索。根据预先指定的标准筛选文章。结果在可能的情况下通过随机效应比例荟萃分析进行汇总。
结果：共有8项队列研究满足所有标准。他们描述了99名患有脑干病变的儿科患者，机器人辅助活检参与了他们的检查.活检时，男性患者62例（63％），女性患者37例（37％），中位年龄为9岁。总的来说,所有患者通过初次活检获得了足够的组织用于评估.在所有研究中，实现肿瘤诊断的汇总估计为100％（95％置信区间[CI]97％-100％），具有高度的确定性。在所有研究中，无手术相关死亡病例.活检后暂时性和永久性并发症的汇总估计值为10%（95%CI4%-19%）和0%（95%CI0%-2%），分别,每个人的确定性都很低和很低。
结论：当代元数据展示了无框架，在有经验的环境中进行小儿脑干病变的机器人辅助活检既有效又安全.需要进一步的研究来将机器人和自动化技术扩展到工作算法中。
