{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T19:08:22Z","timestamp":1793732902803,"version":"4.6.1"},"reference-count":76,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,3,3]],"date-time":"2021-03-03T00:00:00Z","timestamp":1614729600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Magnetic resonance\u2010guided laser interstitial laser therapy (MRgLITT) and radiofrequency ablation (RFA) represent two minimally invasive methods for the treatment of drug\u2010refractory mesial temporal lobe epilepsy (mTLE). We performed a systematic review and a meta\u2010analysis to compare outcomes and complications between MRgLITT, RFA, and conventional surgical approaches to the temporal lobe (i.e., anterior temporal lobe resection [ATL] or selective amygdalohippocampectomy [sAHE]). Forty\u2010three studies (13 MRgLITT, 6 RFA, and 24 surgery studies) involved 554, 123, 1504, and 1326 patients treated by MRgLITT, RFA, ATL, or sAHE, respectively. Engel Class I (Engel\u2010I) outcomes were achieved after MRgLITT in 57% (315\/554, range = 33.3%\u201367.4%), RFA in 44% (54\/123, range = 0%\u201367.2%), ATL in 69% (1032\/1504, range = 40%\u201392.9%), and sAHE in 66% (887\/1326, range = 21.4%\u201393.3%). Meta\u2010analysis revealed no significant difference in seizure outcome between MRgLITT and RFA (\n                    <jats:italic>Q<\/jats:italic>\n                    \u00a0=\u00a02.74,\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a0.098), whereas ATL and sAHE were both superior to MRgLITT (ATL:\n                    <jats:italic>Q<\/jats:italic>\n                    \u00a0=\u00a08.92,\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a0.002; sAHE:\n                    <jats:italic>Q<\/jats:italic>\n                    \u00a0=\u00a04.33,\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a0.037) and RFA (ATL:\n                    <jats:italic>Q<\/jats:italic>\n                    \u00a0=\u00a06.42,\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a0.0113; sAHE:\n                    <jats:italic>Q<\/jats:italic>\n                    \u00a0=\u00a05.04,\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a0.0247), with better outcome in patients at follow\u2010up of 60\u00a0months or more. Mesial hippocampal sclerosis (mTLE + hippocampal sclerosis) was associated with significantly better outcome after MRgLITT (Engel\u2010I outcome in 64%;\n                    <jats:italic>Q<\/jats:italic>\n                    \u00a0=\u00a08.55,\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a0.0035). The rate of major complications was 3.8% for MRgLITT, 3.7% for RFA, 10.9% for ATL, and 7.4% for sAHE; the differences did not show statistical significance. Neuropsychological deficits occurred after all procedures, with left\u2010sided surgeries having a higher rate of verbal memory impairment. Lateral functions such as naming or object recognition may be more preserved in MRgLITT. Thermal therapies are effective techniques but show a significantly lower rate of Engel\u2010I outcome in comparison to ATL and sAHE. Between MRgLITT and RFA there were no significant differences in Engel\u2010I outcome, whereby the success of treatment seems to depend on the approach used (e.g., occipital approach). MRgLITT shows a similar rate of complications compared to RFA, whereas patients undergoing MRgLITT may experience fewer major complications compared to ATL or sAHE and might have a more beneficial neuropsychological outcome.\n                  <\/jats:p>","DOI":"10.1111\/epi.16846","type":"journal-article","created":{"date-parts":[[2021,3,3]],"date-time":"2021-03-03T06:56:20Z","timestamp":1614754580000},"page":"831-845","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":126,"title":["Comparison of minimally invasive and traditional surgical approaches for refractory mesial temporal lobe epilepsy: A systematic review and meta\u2010analysis of outcomes"],"prefix":"10.1111","volume":"62","author":[{"given":"Konstantin","family":"Kohlhase","sequence":"first","affiliation":[{"name":"Department of Neurology Epilepsy Center Frankfurt Rhine\u2010Main University Hospital Frankfurt Frankfurt am Main Germany"},{"name":"Landes\u2010Offensive 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