الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Background: Recently, successful Neuroendoscopy has relied on the success of endoscopic third ventriculostomy for management of obstructive hydrocephalus. However, Neuroendoscopy is extending itself beyond just ventriculostomy approaches. It is now utilized for treatment of intraventricular tumours. Fukushima was the first to report the usage of Neuroendoscopy in intraventricular tumours biopsy. Additionally, the endoscope has been utilized for removal of colloid cyst and other intraventricular lesions. It is reported a low rate of hemorrhagic sequalae from neuroendoscopic procedures involving intraventricular tumours. The neuroendoscope has the capability to perform tumour dissection, biopsy, relief of hydrocephalus, and CSF sampling in one procedure. Planning of the operative approach for such procedures could even be facilitated with frameless stereotactic guidance. Not all intraventricular tumours can be totally removed by neuroendoscopy. It depends on multiple factors like tumour size, vascularity, site, and relation to important structures. Tumours that cannot be totally removed by endoscope can be reattacked by open surgery (trans callosal or transcortical) in assistance with neuroendoscopy or taking radiotherapy. The aim of the work: to compare between totally endoscopic and endoscopic assisted approaches in the management of intraventricular brain tumours. Patients: Twenty cases were included in the study and they were divided into two groups; group I included 10 cases who underwent totally endoscopic approach, and group II included the other 10 cases who underwent the endoscopic assisted technique.
Methods: All cases were subjected to complete history taking, physical and neurological examination, routine preoperative laboratory tests, and preoperative imaging (CT and MRI). Results: Patient demographics did not differ between the two study groups. However, group II had a significantly larger tumour size (p < 0.001). Additionally, third ventricle was the commonest tumour location in group I (9 cases – 90%), while lateral ventricle was for the 1st group (7 cases – 70%). Tumour type was also different between the two groups as colloid cyst was the commonest in group I whereas central neurocytoma was for group II (p = 0.026). Operative time was significantly shorter for the totally endoscopic group (5 vs, 6 hours- p = 0.003). In addition, post-operative complications did not differ significantly between the two study groups (p > 0.05). Post-operative residual was detected by CT in all group I cases whereas only detected in 6 cases in group II. Conclusion: Totally endoscopic approaches are better than endoscopic assisted technique regarding operative time and tumour manipulation. Nevertheless, dealing with intraventricular hemorrhage as well as large tumours are better with the endoscopic assisted approaches. However, totally endoscopic approaches are associated with higher chance of post-operative tumour residual diagnosed by brain CT or MRI. Recommendations: Using totally endoscopic approaches for smaller intraventricular tumours.