PDF(Pubmed)
Abstract：
UNASSIGNED: The advancement of pituitary surgery has rendered it a secure and efficient treatment method; nevertheless, the potential for incomplete tumor removal and cerebrospinal fluid (CSF) leak remains. Neuronavigation-assisted pituitary neuroendocrine tumor (PitNET) resections have been driving a rising number of attentions in recent years. However, there is currently a lack of comprehensive quantitative evaluation of the effectiveness of neuronavigation-assisted pituitary tumor resection. We aimed to assess the curative effects and complications with or without the use of an image-based neuronavigation in PitNET resection.
UNASSIGNED: A systematic review and meta-analysis was performed by searching PubMed, EMBASE, Cochrane Library, Web of Science, and Scopus from inception until May 1, 2024 in English to identify any studies reporting gross total resection (GTR) or postoperative complications in patients who underwent neuronavigation-assisted PitNET resection, excluding conference abstracts and studies with fewer than five subjects. We also searched the reference lists of previous systematic reviews and other relevant publications in databases. We reviewed and analyzed the studies that investigated the operative effects and complications of neuronavigation in PitNET resection. Study quality was assessed by the Newcastle-Ottawa scale, and publication bias was evaluated by funnel plot. Review manager 5.3 was employed for meta-analysis. The results were expressed as odds ratio (OR) with 95% confidence interval (CI) of image-assisted techniques for the incidence of GTR and complications.
UNASSIGNED: A total of 42 publications that fulfilled the established searching criteria were obtained from the above-mentioned databases, all of which with the Newcastle-Ottawa Scale scores ≥ six ★. Among the included publications, 37 studies indicated that the OR of image-based neuronavigation was 2.29 (95% CI: 2.02-2.60, P<0.00001, I2=24%) for GTR. The other five studies compared the neuronavigation group (experimental group) and non-neuronavigation group (control group), exhibiting high heterogeneity (I2=91%). After sensitivity analysis, the results showed that the rate of the CSF leak of the neuronavigation group was slightly lower than that of the non-neuronavigation group (OR: 0.84, 95% CI: 0.73-0.97, P=0.01, I2=43%).
UNASSIGNED: According to the existing data, neuronavigation-assisted PitNET resection can increase the rates of GTR and reduce the incidence of postoperative complications. Our results provide a reference for the selection of surgical methods for PitNET resection in future clinical practice.
UNASSIGNED: A systematic review and meta-analysis was performed by searching PubMed, EMBASE, Cochrane Library, Web of Science, and Scopus from inception until May 1, 2024 in English to identify any studies reporting gross total resection (GTR) or postoperative complications in patients who underwent neuronavigation-assisted PitNET resection, excluding conference abstracts and studies with fewer than five subjects. We also searched the reference lists of previous systematic reviews and other relevant publications in databases. We reviewed and analyzed the studies that investigated the operative effects and complications of neuronavigation in PitNET resection. Study quality was assessed by the Newcastle-Ottawa scale, and publication bias was evaluated by funnel plot. Review manager 5.3 was employed for meta-analysis. The results were expressed as odds ratio (OR) with 95% confidence interval (CI) of image-assisted techniques for the incidence of GTR and complications.
UNASSIGNED: A total of 42 publications that fulfilled the established searching criteria were obtained from the above-mentioned databases, all of which with the Newcastle-Ottawa Scale scores ≥ six ★. Among the included publications, 37 studies indicated that the OR of image-based neuronavigation was 2.29 (95% CI: 2.02-2.60, P<0.00001, I2=24%) for GTR. The other five studies compared the neuronavigation group (experimental group) and non-neuronavigation group (control group), exhibiting high heterogeneity (I2=91%). After sensitivity analysis, the results showed that the rate of the CSF leak of the neuronavigation group was slightly lower than that of the non-neuronavigation group (OR: 0.84, 95% CI: 0.73-0.97, P=0.01, I2=43%).
UNASSIGNED: According to the existing data, neuronavigation-assisted PitNET resection can increase the rates of GTR and reduce the incidence of postoperative complications. Our results provide a reference for the selection of surgical methods for PitNET resection in future clinical practice.
摘要：
■垂体手术的发展使其成为一种安全有效的治疗方法；尽管如此，肿瘤切除不完全和脑脊液(CSF)渗漏的可能性仍然存在.近年来，神经导航辅助的垂体神经内分泌肿瘤（PitNET）切除术引起了越来越多的关注。然而,目前缺乏对神经导航辅助垂体瘤切除术有效性的全面定量评价。我们旨在评估在PitNET切除术中使用或不使用基于图像的神经导航的疗效和并发症。
■通过搜索PubMed，EMBASE,科克伦图书馆,WebofScience,和Scopus从开始到2024年5月1日的英语，以确定任何报告接受神经导航辅助PitNET切除术的患者的总体全切除（GTR）或术后并发症的研究，不包括少于五个科目的会议摘要和研究。我们还在数据库中检索了以前的系统综述和其他相关出版物的参考文献列表。我们回顾并分析了研究PitNET切除术中神经导航的手术效果和并发症的研究。研究质量通过纽卡斯尔-渥太华量表进行评估，发表偏倚采用漏斗图评价。审查经理5.3被用于荟萃分析。结果表示为图像辅助技术对GTR和并发症发生率的比值比（OR）和95％置信区间（CI）。
■从上述数据库中获得了总共42种符合既定搜索标准的出版物，所有这些与纽卡斯尔-渥太华量表得分≥6★。在包括的出版物中，37项研究表明，基于图像的神经导航对GTR的OR为2.29（95％CI：2.02-2.60，P<0.00001，I2=24％）。其他五项研究比较了神经导航组(实验组)和非神经导航组(对照组),表现出高异质性(I2=91%)。经过敏感性分析，结果表明，神经导航组的CSF泄漏率略低于非神经导航组（OR：0.84，95％CI：0.73-0.97，P=0.01，I2=43％）。
■根据现有数据，神经导航辅助PitNET切除可以提高GTR的发生率，降低术后并发症的发生率。我们的结果为今后临床实践中PitNET切除手术方法的选择提供了参考。
■通过搜索PubMed，EMBASE,科克伦图书馆,WebofScience,和Scopus从开始到2024年5月1日的英语，以确定任何报告接受神经导航辅助PitNET切除术的患者的总体全切除（GTR）或术后并发症的研究，不包括少于五个科目的会议摘要和研究。我们还在数据库中检索了以前的系统综述和其他相关出版物的参考文献列表。我们回顾并分析了研究PitNET切除术中神经导航的手术效果和并发症的研究。研究质量通过纽卡斯尔-渥太华量表进行评估，发表偏倚采用漏斗图评价。审查经理5.3被用于荟萃分析。结果表示为图像辅助技术对GTR和并发症发生率的比值比（OR）和95％置信区间（CI）。
■从上述数据库中获得了总共42种符合既定搜索标准的出版物，所有这些与纽卡斯尔-渥太华量表得分≥6★。在包括的出版物中，37项研究表明，基于图像的神经导航对GTR的OR为2.29（95％CI：2.02-2.60，P<0.00001，I2=24％）。其他五项研究比较了神经导航组(实验组)和非神经导航组(对照组),表现出高异质性(I2=91%)。经过敏感性分析，结果表明，神经导航组的CSF泄漏率略低于非神经导航组（OR：0.84，95％CI：0.73-0.97，P=0.01，I2=43％）。
■根据现有数据，神经导航辅助PitNET切除可以提高GTR的发生率，降低术后并发症的发生率。我们的结果为今后临床实践中PitNET切除手术方法的选择提供了参考。
