World Neurosurg
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Review Meta Analysis
The Prognostic Utility of Frailty on the Outcomes of Primary Brain Tumor Surgery Patients: A Meta-analysis.
Frailty refers to a state of weakness that can arise due to age or illnesses, and frailty predisposes individuals to several adverse health outcomes. This has been postulated to prognosticate the outcome of various surgeries, including surgeries for primary brain tumors; however, no meta-analysis has validated this finding. ⋯ This study showed little correlation with postoperative mortality, readmission, nonroutine discharge, length of hospital stay, or overall survival, and fragility had less significance in these areas but showed no statistical significance in predicting postoperative complications following surgery for primary brain tumors.
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Review Meta Analysis
Friend or Foe? Preoperative Embolization in Jugular Paraganglioma Surgery-A Systematic Review and Meta-Analysis.
Jugular paragangliomas are highly vascularized tumors that can grow in challenging neurovascular compartments and are particularly challenging to resect. There is still no consensus whether preoperative embolization should be employed to minimize intraoperative morbidity. ⋯ Preoperative embolization may provide surgical efficiency with faster surgical times and less bleeding and safety with diminished overall recurrence via safe embolization with minimal risks. These results must be considered taking into account the nonrandomness of studies.
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Review Meta Analysis
Pituitary Apoplexy and The Current Understanding of Its Management: A Meta-Analysis of 908 Patients.
Pituitary apoplexy (PA) is characterized by acute hemorrhage or infarction of the pituitary gland. Management can be either conservative or surgical. Evidence favoring either is still limited to observational studies. This meta-analysis evaluates the effectiveness of both approaches on patient outcomes. ⋯ Both interventions provide comparable outcomes. These findings, though, are drawn from observational studies, and more severe cases typically undergo surgery. Larger studies are necessary to provide conclusive evidence.
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Comparative Study
Single-Level Unilateral Biportal Endoscopic versus Tubular Microdiscectomy: Comparing Surgical Outcomes and Opioid Consumption.
Unilateral biportal endoscopic (UBE) microdiscectomy is an emerging minimally invasive surgery technique for treating symptomatic lumbar disc herniation. There is limited literature regarding outcomes. Here, we assess surgical outcomes and pain medication consumption for UBE vs. tubular lumbar microdiscectomy. ⋯ UBE microdiscectomy is associated with longer operating times. Both opioid and nonopioid pain medication consumption were lower for UBE patients during the initial postoperative period, perhaps owing to the less-invasive nature of the surgery.
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Stereotactic radiosurgery (SRS) is an established treatment for intracranial meningioma, yet this approach is often precluded by tumor size or proximity to critical structures. Fractionated radiotherapy (RT) may be employed to address these limitations. We performed a comparison of local control (LC) outcomes between 3 stereotactic techniques. ⋯ Durable LC was observed at long-term follow-up of intracranial meningioma treated with stereotactic radiosurgery and RT. LC outcomes were similar across the 3 fractionation regimens, suggesting that clinicians may tailor RT recommendations based on clinical factors without concern for reduced efficacy.