Early Experience With Laser Interstitial Thermal Therapy Corpus Callosotomy Suggests Durable Clinical and Safety Outcomes at 1-year Follow-up
Abstract number :
3.44
Submission category :
9. Surgery / 9B. Pediatrics
Year :
2022
Submission ID :
2232961
Source :
www.aesnet.org
Presentation date :
12/5/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:29 AM
Authors :
H. Westley Phillips, MD – UPMC, Children's Hospital of Pittsburgh; Jasmine Hect, BS – UPMC, Children's Hospital of Pittsburgh; Emily Harford, BS – UPMC, Children's Hospital of Pittsburgh; Evelyn Pan, BS – UPMC, Children's Hospital of Pittsburgh; Taylor Abel, MD – UPMC, Children's Hospital of Pittsburgh
This is a Late Breaking abstract
Rationale: Corpus Callosotomy (CC) is an important treatment for drop attack seizures in patients with generalized or multi-focal drug-resistant epilepsy (DRE). Traditionally, CC is performed via open craniotomy utilizing the interhemispheric approach, but more recently, MR-guided stereotactic laser interstitial thermal therapy corpus callosotomy (LITT-CC) has been developed given the safety and minimally invasiveness of LITT in other contexts. Given the recent adoption of LITT-CC in select centers, there is dearth of literature describing its durability and effectiveness for seizure palliation. We aim to describe our institutional experience with LITT-CC and compare surgical variables and seizure outcomes between approaches at 1-year follow-up.
Methods: We performed a retrospective cohort study to compare safety and effectiveness of traditional CC to LITT-CC from 1994-2022. Primary outcome was the difference between 50% reduction of target seizure at 1-year follow-up. Secondary outcomes included other measures of effectiveness, complications, and hospital length of stay. Comparative statistics were executed using Stata SE. Normality for continuous variables were assessed and parametric statistics were utilized as needed. Frequency was compared with chi-squared or Fischer’s exact tests when applicable.
Results: In total, data from 47 operations performed on 36 patients were included in this study of which 13 (36%) patients underwent 17 LITT-CC. There was no significant difference in rates of post-operative complications between the groups, although rates trended lower in the LITT-CC cohort (12% vs 23% p=0.45). Patients undergoing LITT-CC had significant shorter hospitalizations than those receiving CC (2.5 days vs 6 days p< 0.001). At 1-year follow-up, patients who received LITT-CC had similar rates of improvement ( >50% reduction) in drop attacks as their CC counterparts (50% vs 67% p=0.29).
Conclusions: This early experience suggests LITT-CC has similar outcomes to traditional CC, albeit with shorter hospital stay. Large multi-center studies are necessary to determine if these findings generalize to a broader population.
Funding: Please list any funding that was received in support of this abstract.: TJA- R21 DC019217/DC/NIDCD NIH, HHS; and TJA- R01 DC013315/DC/NIDCD, NIH HHS
Surgery