Abstract：
Pediatric optic pathway/hypothalamic gliomas (OPHG) pose challenges in treatment due to their location and proximity to vital structures. Surgical resection plays a key role in the management of OPHG especially when the tumor exhibits mass effect and causes symptoms. However, data regarding outcomes and complications of surgical resection for OPHG remains heterogenous. The authors performed a systematic review on pediatric OPHG in four databases: PubMed, EMBASE, Cochrane Library, and Google Scholar. We included studies that reported on the visual outcomes and complications of OPHG resection. A meta-analysis was performed and reported per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A total of 26 retrospective studies were included. Seven hundred ninety-seven pediatric patients with OPHG undergoing surgical resection were examined. A diagnosis of NF1 was confirmed in 9.7%. Gross total resection was achieved in 36.7%. Intraorbital optic pathway gliomas showed a significantly higher gross total resection rate compared to those located in the chiasmatic/hypothalamic region (75.8% vs. 9.6%). Postoperatively, visual acuity improved in 24.6%, remained unchanged in 68.2%, and worsened in 18.2%. Complications included hydrocephalus (35.4%), anterior pituitary dysfunction (19.6%), and transient diabetes insipidus (29%). Tumor progression post-resection occurred in 12.8%, through a mean follow-up of 53.5 months. Surgical resection remains an essential strategy for treating symptomatic and large pediatric OPHG and can result in favorable vision outcomes in most patients. Careful patient selection is critical. Patients should be monitored for hydrocephalus development postoperatively and followed up to assess for tumor progression and adjuvant treatment necessity.
摘要：
小儿视路/下丘脑胶质瘤（OPHG）由于其位置和与重要结构的接近性而在治疗中提出了挑战。手术切除在OPHG的治疗中起着关键作用，尤其是当肿瘤表现出肿块效应并引起症状时。然而,关于OPHG手术切除结果和并发症的数据仍然不一致.作者在四个数据库中对儿科OPHG进行了系统评价：PubMed，EMBASE,科克伦图书馆,谷歌学者。我们纳入了有关OPHG切除术的视觉结果和并发症的研究。根据系统评价和荟萃分析（PRISMA）声明的首选报告项目进行荟萃分析并报告。共纳入26项回顾性研究。检查了797例接受手术切除的OPHG儿科患者。在9.7%中确认了NF1的诊断。总切除率为36.7%。与位于交叉/下丘脑区域的患者相比，眶内视路胶质瘤显示出明显更高的总切除率（75.8％vs.9.6%）。术后,视力提高了24.6%，68.2%保持不变，恶化为18.2%。并发症包括脑积水（35.4%），垂体前叶功能障碍（19.6%），短暂性尿崩症（29%）。切除后肿瘤进展发生率为12.8%，平均随访53.5个月。手术切除仍然是治疗症状性和大型小儿OPHG的重要策略，并且可以在大多数患者中产生良好的视力结果。仔细选择病人是至关重要的。术后应监测患者脑积水的发展，并随访以评估肿瘤进展和辅助治疗的必要性。
