• Davi Amorim Meira, Silvio Porto Júnior, Beatriz Lopes Bernardo da Cunha, Jefferson Heber Marques Fontes, Hugo Nunes Pustilnik, Matheus Gomes da Silva da Paz, Tancredo Alcântara, and Leonardo Miranda de Avellar.
• Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil. Electronic address: daviamorimmmeira@gmail.com.
• World Neurosurg. 2024 Apr 1; 184: e708e719e708-e719.

ObjectiveTo assess the efficacy and surgical outcomes of the simultaneous single-trajectory endoscopic biopsy and third ventriculostomy (ETV) in pineal region tumors.MethodsA systematic review and meta-analysis adhering to Cochrane Standards and PRISMA framework were conducted. PubMed, Embase, and Web Of Science databases were searched until December 2023. Outcomes included rate of histopathologic diagnosis success, ETV success, complications, required VPS, and mortality.ResultsSeventeen studies (N = 388) met inclusion criteria. Histopathologic diagnosis success rate was 90% for general population (95% CI: 86%-95%; I2 = 42%) and 94% for pediatric patients (95% CI: 89%-98%; I2 = 19%). ETV Success rate was 93% (95% CI: 88%-97%; I2 = 60%). An estimated risk of postoperative ETV complications was found to be 16% for the general population (95% CI: 5%-28%; I2 = 90%) and 5% for pediatric patients (95% CI: 0%-13%; I2 = 51%). The risk of requiring VPS was estimated as 2% (95% CI: 0%-4%; I2 = 39%) and for the pediatric population it was 7% (95% CI: 0%-16%; I2 = 69%). Mortality risk was found to be 1% (95% CI: 0%-3%; I2 = 0%).ConclusionsSimultaneous endoscopic biopsy and ETV demonstrated high diagnostic and therapeutic success rates. The procedure's safety profile, with low mortality and complications, supports its role in treating hydrocephalus associated to pineal region tumors. Subgroup analyses revealed higher diagnostic success rates and required VPS in the pediatric population, whilst it had lower complication rates.Copyright © 2024 Elsevier Inc. All rights reserved.

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