Comparative Metrics for Laser Interstitial Thermal Therapy (LITT) Versus Open Corpus Callosotomy: A Single-Institution Experience
Abstract number :
2.26
Submission category :
9. Surgery / 9B. Pediatrics
Year :
2021
Submission ID :
1825962
Source :
www.aesnet.org
Presentation date :
12/5/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:51 AM
Authors :
Josue D Ordaz, MD - Indiana University; Virendra Desai, MD - Fellow, Neurological Surgery, Indiana University; Andrew Huh, MD - Resident Physician, Neurological Surgery, Indiana University; Rupa Radhakrishnan, MBBS - Assistant Professor, Radiology, Indiana University; Jeffrey Raskin, MD MS - Assistant Professor, Neurological Surgery, Indiana University
Rationale: Corpus callosotomy (CC) is a palliative treatment for medically refractory epilepsy characterized with drop and generalized seizures. CC has conventionally been performed by an open craniotomy (open) and resection, but this approach presents potential risks of; post-operative hydrocephalus, hemorrhage, infection and stroke. To mitigate these risks, laser interstitial thermal therapy (LITT) has been used as a minimally invasive alternative to ablate the corpus callosum. We present a single-institution experience comparison between conventional open CC and LITT CC.
Methods: All patients who underwent a corpus callosotomy between January 2019 to January 2021 at Riley Hospital for Children were included. Retrospective chart review was performed to identify factors such as; demographics, pre- and post-operative seizure frequency, number of drop seizures, Engel classification for seizure outcome, hospital charges, hospital length of stay and operative complications. Data analysis was performed using GraphPad Prism 9. Two-tailed t-test were performed for continuous variables and an alpha value .05 was used.
Results: Fourteen total patients were included in this study. There were 11 and 3 patients in the LITT and open CC groups, respectively. The average age was 11.4 in the LITT and 6.7 years in the open groups. Preoperative drop seizures were more common in the open CC group (32.2 vs 10.4 seizure per day P= .19). Postoperative drop seizures were also more frequent in the open CC group (17.3 vs 2.3 seizures per day P= .074) compared to LITT CC. Percent decrease in drop seizures was higher in the LITT group (65% vs 78%, P= .48). Three of the patients who underwent LITT and 1 in the open group had Engle class 1 seizure outcome (33% vs 27%). Furthermore, 2/3 of the patients in the open group developed post-operative hydrocephalus, whereas none was documented in the LITT group.
Conclusions: Collective data to date suggest that LITT CC is efficacious and presents a low rate of hydrocephalus development. The results presented indicate this laser aided procedure may be a safer and more efficacious alternative to the traditional open corpus callosotomy. This study is limited by the number of patients hence further multicenter study is needed.
Funding: Please list any funding that was received in support of this abstract.: None.
Surgery