{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:02:08Z","timestamp":1787025728627,"version":"build-2736575974"},"reference-count":19,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2013,6]]},"abstract":"<jats:sec>\n                    <jats:title>Object<\/jats:title>\n                    <jats:p>Analysis of the safety and morbidity of neuroendoscopic biopsies (NEBs), as well as the reliability in obtaining an accurate diagnosis, has until now been based on studies with relatively small sample sizes. Through the cooperative efforts of several international medical centers, authors of the present study collected data on a large number of patients to obtain better insight into this issue. When possible, they compared pathology obtained through an NEB with the \u201cgold-standard\u201d pathology obtained in open surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Thirteen randomly chosen medical centers in 9 countries collected data for patients who had undergone NEB, which were then analyzed for universal complications, bleeding, navigation technique, pathology, mismatch between biopsy results and final diagnosis, and a number of other potentially influential factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Data for 293 patients were analyzed. Sixty percent of the patients were male, and patient ages ranged from 0.1 to 78.7 years (median age 20.4 years). The most common tumor locations were pineal (33.1%), thalamic (16.7%), tectal (13%), and hypothalamic (4.4%). Fifty percent of the tumors were larger than 20 mm, 36% were between 10 and 20 mm, and 14% were smaller than 10 mm. Intraoperative bleeding was seen in 275 patients (94%). The amount of blood was noted as mild in 75%, moderate in 13%, and severe in 6%. Infection occurred in 8 patients (3%). Death occurred in 1 patient (0.3%), which was caused by severe intraoperative bleeding. Biopsies were informative in 265 patients (90.4%). Seventy-eight patients (26.6%) had open surgery following the NEB. For these patients, the pathology results from the NEB were compared with those from the open surgery that followed. In 14 cases (17.9%) there was disagreement on the pathology. Of these cases, a meaningful mismatch, in which the erroneous NEB pathology could have led to an inappropriate management decision, occurred in 9 cases (11.5%). Most of these meaningful mismatches were lesions diagnosed as low-grade or pilocytic astrocytoma on the NEB and later proved to be high-grade astrocytoma (4 cases) and 1 case each of meningioma, cavernoma, primitive neuroectodermal tumor, neurocysticercosis, and pineocytoma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In experienced hands, NEBs can be performed with low morbidity and mortality, providing meaningful pathological data for the majority of patients with a wide range of tumor types, locations, and presentations. These biopsies also offer other advantages, such as the ability to perform concomitant endoscopic third ventriculostomy and septum pellucidotomy. However, due caution must be maintained, since pathology obtained from an NEB, as with stereotactic biopsies, may be subject to sampling errors, especially when the results seem to indicate a low-grade glial tumor.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2013.3.peds12416","type":"journal-article","created":{"date-parts":[[2013,4,12]],"date-time":"2013-04-12T10:04:02Z","timestamp":1365761042000},"page":"704-709","source":"Crossref","is-referenced-by-count":68,"title":["Safety and diagnostic accuracy of neuroendoscopic biopsies: an international multicenter study"],"prefix":"10.3171","volume":"11","author":[{"given":"Shlomi","family":"Constantini","sequence":"first","affiliation":[{"name":"Department of Pediatric Neurosurgery, Dana Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron","family":"Mohanty","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, University of Texas Medical Branch at Galveston, Texas;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Zymberg","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurosurgery, Division of Neurosurgery, Federal University of S\u00e3o Paulo, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Cavalheiro","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurosurgery, Division of Neurosurgery, Federal University of S\u00e3o Paulo, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Conor","family":"Mallucci","sequence":"additional","affiliation":[{"name":"Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dieter","family":"Hellwig","sequence":"additional","affiliation":[{"name":"Department of Stereotactic and Functional Neurosurgery, International Neuroscience Institute, Hannover, Germany;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuf","family":"Ersahin","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Department of Neurosurgery, Ege University Faculty of Medicine, Izmir, Turkey;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Mori","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sannocho Hospital, Sanjo City, Niigata, Japan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmelo","family":"Mascari","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Bellaria Hospital, University of Bologna, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Aloysio Costa","family":"Val","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurosurgery, Biocor Institute, Nova Lima, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang","family":"Wagner","sequence":"additional","affiliation":[{"name":"Section of Pediatric Neurosurgery, Department of Neurosurgery, University Hospitals, Mainz, Germany;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhaya V.","family":"Kulkarni","sequence":"additional","affiliation":[{"name":"The Hospital for Sick Children, Toronto, Ontario, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Spyros","family":"Sgouros","sequence":"additional","affiliation":[{"name":"University of Athens Medical School and Department of Pediatric Neurosurgery, Mitera Children's Hospital, Athens, Greece; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shizuo","family":"Oi","sequence":"additional","affiliation":[{"name":"Jikei University School of Medicine, Minato-ku, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-peds12416","series-title":"J Child Neurol","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1177\/0883073809340318","article-title":"Endoscopic management of intraventricular brain tumors in pediatric patients: a review of indications, techniques, and outcomes","volume":"25","author":"Ahmad","year":"2010"},{"key":"b2-peds12416","series-title":"J Neurosurg Pediatr","doi-asserted-by":"publisher","first-page":"255","DOI":"10.3171\/2009.10.PEDS09172","article-title":"Endoscopic biopsy of brain tumors in children: diagnostic success and utility in guiding treatment strategies. 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