Authors :
Presenting Author: Takehiro Uda, MD – Osaka Metropolitan University
Vich Yindeedej, MD – Neurosurgery – Osaka Metropolitan University; Yuta Tanoue, MD – Neurosurgery – Osaka Metropolitan University; Toshiyuki Kawashima, MD – Neurosurgery – Osaka Metropolitan University; saya Koh, MD – Neurosurgery – Osaka Metropolitan University; yuichiro Kojima, MD – Neurosurgery – Osaka Metropolitan University; noritsugu Kunihiro, MD – Pediatric Neurosurgery – Osaka City General Hospital; ryoko Umaba, MD – Pediatric Neurosurgery – Osaka City General Hospital; Takeo Goto, MD – Neurosurgery – Osaka Metropolitan University
Rationale:
Corpus callosotomy (CC) is an epilepsy surgery that disconnects the commissural fibers at the corpus callosum, a structure that often plays a key role in propagating seizure activity. CC is particularly beneficial in patients with drop attacks. Less-invasive endoscopic surgeries have recently been introduced to some fields of neurosurgery, but have not yet become common in epilepsy surgery. Endoscopic surgeries offer better visualization and require a smaller corridor than conventional microscopic surgeries. Here, we presented a case series comparing endoscopic CC with microscopic CC.
Methods:
This two-center retrospective study involved patients who underwent all types of CC (anterior, total, or posterior CC) between January 2014 and May 2022. We excluded patients who underwent additional craniotomy for electrocorticography rather than CC, prior craniotomy, or CC without craniotomy. The primary outcomes were comparing size of craniotomy, operative time and surgical complications between endoscopic CC and microscopic CC.
Results:
We included 14 CCs in 11 patients in the endoscopic group and 58 CCs in 55 patients in the microscopic group. No significant difference in age was seen between groups. Craniotomies were significantly smaller in the endoscopic group for anterior (13.36 ± 1.31 cm2 vs 27.55 ± 3.78 cm2; p=0.001), total (14.07 ± 2.54 cm2 vs 26.63 ± 6.97 cm2; p=0.001), and posterior CC (9.44 ± 1.18 cm2 vs 30.23 ± 10.76 cm2; p=0.002). Moreover, no significant differences in operative time (aCC [261 ± 53.11 min vs 298.73 ± 81.08 min, p=0.226], tCC [339.5 ± 48.2 min vs 321.39 ± 65.98 min, p=0.452], pCC [198 ± 24.73 min vs 242.5 ± 59.12 min, p=0.240]) or complication rate were seen.Conclusions:
Endoscopic CC is a promising technique requiring a smaller craniotomy than microscopic CC, without significantly increasing operative time or complication rate compared with microscopic CC.Funding: None