| Título : |
Efficacy and safety of endoscopic compared with open surgical repair of cerebrospinal fluid fistulas: a systematic review and meta-analysis |
| Tipo de documento : |
documento electrónico |
| Autores : |
Francisco Javier Londoño Ocampo, Autor ; Frusteri, Marco, Autor ; Gaviria Zapata, Miguel, Autor ; Suárez Sepúlveda, Juan Esteban, Autor ; Rivas, Carlos, Autor ; Quiceno, Esteban, Autor ; Londoño Herrera, Daniel, Autor |
| Fecha de publicación : |
2025 |
| Títulos uniformes : |
Neurosurgical Review
|
| Idioma : |
Inglés (eng) Idioma original : Inglés (eng) |
| Palabras clave : |
Cerebrospinal fluid leak; Endoscopy; Neurosurgery. |
| Resumen : |
Background and objective: Cerebrospinal fluid leaks or fistulas are a relatively common neurosurgical pathology. Classically, this condition has been managed through an open surgical approach, but endoscopic surgery has emerged as a less invasive alternative with several advantages. Despite this, no meta-analysis has yet directly compared the clinical outcomes of these two management strategies. Methods: A systematic review and meta-analysis were conducted following PRISMA guidelines. The PubMed, Embase, LILACS and Web of Science databases were rigoursly searched. Post-operative repair success rate, risk of recurrence and the risk of presenting any operation-related compilation and the all-cause mortality rate were analyzed. Data were analyzed using a common-effects meta-analysis, and statistical heterogeneity was assessed. The study was registered with PROSPERO (CRD42024606877). Results: Seven studies comprising 360 patients (140 endoscopic, 220 open) were included. Although the point estimate suggested a higher success rate with endoscopic repair, the difference was not statistically significant OR 1.32 (95% CI 0.55-3.16, I2 = 4.4%). The complication rate was significantly lower in the endoscopic group OR 0.26 (95% CI 0.10-0.67, I2 = 38%) and a leave-one-out analysis excluding the study by Gassner et al. found OR 0.10 (95% CI 0.03-0.32, I2 = 0%). Recurrence of CSF fistulas showed a trend favoring endoscopic repair (OR 0.78, 95% CI 0.42-1.43, I2 = 0%). No mortality was reported. Conclusions: Endoscopic CSF fistula repair demonstrates a superior safety profile and is non-inferior in terms of efficacy compared to open surgery. Given the limited number of high-quality studies, further research is needed and larger, well-designed studies are recommended to refine clinical decision-making and optimize patient care. |
| Mención de responsabilidad : |
Marco Frusteri, Miguel Gaviria Zapata, Juan Esteban Suárez Sepúlveda, Carlos Rivas, Esteban Quiceno, Daniel Londoño Herrera, Francisco Javier Londoño Ocampo |
| Referencia : |
Neurosurg Rev. 2025 Jul 15;48(1):567. doi: 10.1007/s10143-025-03686-9. |
| DOI (Digital Object Identifier) : |
10.1007/s10143-025-03754-0 |
| PMID : |
40779209 |
| Derechos de uso : |
CC BY-NC-ND |
| En línea : |
https://pubmed.ncbi.nlm.nih.gov/40663243/ |
| Enlace permanente : |
https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis |
Efficacy and safety of endoscopic compared with open surgical repair of cerebrospinal fluid fistulas: a systematic review and meta-analysis [documento electrónico] / Francisco Javier Londoño Ocampo, Autor ; Frusteri, Marco, Autor ; Gaviria Zapata, Miguel, Autor ; Suárez Sepúlveda, Juan Esteban, Autor ; Rivas, Carlos, Autor ; Quiceno, Esteban, Autor ; Londoño Herrera, Daniel, Autor . - 2025. Obra : Neurosurgical ReviewIdioma : Inglés ( eng) Idioma original : Inglés ( eng)
| Palabras clave : |
Cerebrospinal fluid leak; Endoscopy; Neurosurgery. |
| Resumen : |
Background and objective: Cerebrospinal fluid leaks or fistulas are a relatively common neurosurgical pathology. Classically, this condition has been managed through an open surgical approach, but endoscopic surgery has emerged as a less invasive alternative with several advantages. Despite this, no meta-analysis has yet directly compared the clinical outcomes of these two management strategies. Methods: A systematic review and meta-analysis were conducted following PRISMA guidelines. The PubMed, Embase, LILACS and Web of Science databases were rigoursly searched. Post-operative repair success rate, risk of recurrence and the risk of presenting any operation-related compilation and the all-cause mortality rate were analyzed. Data were analyzed using a common-effects meta-analysis, and statistical heterogeneity was assessed. The study was registered with PROSPERO (CRD42024606877). Results: Seven studies comprising 360 patients (140 endoscopic, 220 open) were included. Although the point estimate suggested a higher success rate with endoscopic repair, the difference was not statistically significant OR 1.32 (95% CI 0.55-3.16, I2 = 4.4%). The complication rate was significantly lower in the endoscopic group OR 0.26 (95% CI 0.10-0.67, I2 = 38%) and a leave-one-out analysis excluding the study by Gassner et al. found OR 0.10 (95% CI 0.03-0.32, I2 = 0%). Recurrence of CSF fistulas showed a trend favoring endoscopic repair (OR 0.78, 95% CI 0.42-1.43, I2 = 0%). No mortality was reported. Conclusions: Endoscopic CSF fistula repair demonstrates a superior safety profile and is non-inferior in terms of efficacy compared to open surgery. Given the limited number of high-quality studies, further research is needed and larger, well-designed studies are recommended to refine clinical decision-making and optimize patient care. |
| Mención de responsabilidad : |
Marco Frusteri, Miguel Gaviria Zapata, Juan Esteban Suárez Sepúlveda, Carlos Rivas, Esteban Quiceno, Daniel Londoño Herrera, Francisco Javier Londoño Ocampo |
| Referencia : |
Neurosurg Rev. 2025 Jul 15;48(1):567. doi: 10.1007/s10143-025-03686-9. |
| DOI (Digital Object Identifier) : |
10.1007/s10143-025-03754-0 |
| PMID : |
40779209 |
| Derechos de uso : |
CC BY-NC-ND |
| En línea : |
https://pubmed.ncbi.nlm.nih.gov/40663243/ |
| Enlace permanente : |
https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis |
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Clasificado(s) por (Año de edición descendente) Refinar búsquedaEfficacy and safety of endoscopic compared with open surgical repair of cerebrospinal fluid fistulas: a systematic review and meta-analysis / Francisco Javier Londoño Ocampo ; Frusteri, Marco ; Gaviria Zapata, Miguel ; Suárez Sepúlveda, Juan Esteban ; Rivas, Carlos ; Quiceno, Esteban ; Londoño Herrera, Daniel
