{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T03:21:41Z","timestamp":1790392901997,"version":"4.1.0"},"reference-count":130,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,1]]},"abstract":"\n OBJECTIVE<\/jats:title>\n Open resective surgery (ORS) has become the standard of care for focal drug-resistant epilepsy (DRE). However, minimally invasive surgical alternatives, such as laser interstitial thermal therapy (LITT), have also been shown to be safe and effective. A meta-analysis comparing both treatments is warranted to assess the benefits of each modality for focal DRE.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n A literature search was conducted until March 14, 2024, to identify studies comparing LITT and ORS in patients with DRE. The primary outcomes included seizure freedom (SF), length of hospital stay (LHS), and complication rate (CR). Subgroup analyses were performed based on age, epilepsy etiology, and propensity score\u2013matched (PSM) studies.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n \n Of 558 articles, 15 cohort studies met the authors\u2019 inclusion criteria, encompassing 3873 patients for analysis. The rate of SF in the LITT group was 52.5% (95% CI 0.453\u20130.597, I\n 2<\/jats:sup>\n = 47.4%) and 67.1% (95% CI 0.602\u20130.739, I\n 2<\/jats:sup>\n = 57.4%) for the ORS group. LITT showed a significantly lower rate of SF compared to ORS (risk ratio [RR] 0.78, 95% CI 0.70\u20130.88, p \u2264 0.0001). However, when PSM studies (RR 0.85, 95% CI 0.63\u20131.15, p = 0.30) and studies on patients with temporal lobe epilepsy (TLE) (RR 0.88, 95% CI 0.67\u20131.14, p = 0.34) were analyzed, the SF rates were similar. Patients who underwent LITT had a significantly shorter LHS (mean difference 2.95 days, 95% CI 1.12\u20134.78, p < 0.00001), lower CR (RR 0.54, 95% CI 0.37\u20130.79, p < 0.002, I\n 2<\/jats:sup>\n = 32%), lower rate of ischemic stroke (RR 0.15, 95% CI 0.04\u20130.65, p = 0.01), and lower rate of permanent neurological deficits (RR 0.13, 95% CI 0.05\u20130.36, p < 0.0001).\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n Across unmatched studies evaluating focal DRE, ORS showed a higher rate of SF. However, pooled matched-cohort analyses showed no difference between interventions in achieving SF, a trend also noted in the authors\u2019 PSM TLE sample. LITT, however, offered significantly shorter LHS and lower CRs. Future prospective studies should match patient populations to control for confounding factors and assess key outcomes, such as postoperative neurocognitive follow-up and quality of life measurements, in order to fully evaluate the risks and benefits of each approach.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2025.4.jns25386","type":"journal-article","created":{"date-parts":[[2025,9,6]],"date-time":"2025-09-06T01:41:09Z","timestamp":1757122869000},"page":"35-54","source":"Crossref","is-referenced-by-count":5,"title":["A comparative assessment of laser interstitial thermal therapy and open resective surgery for drug-resistant epilepsy: a meta-analysis of 3873 patients"],"prefix":"10.3171","volume":"144","author":[{"given":"Diego","family":"Pichardo-Rojas","sequence":"first","affiliation":[{"name":"Epilepsy Surgery Department, Instituto Nacional de Neurolog\u00eda y Neurocirug\u00eda \"Manuel Velasco Su\u00e1rez,\" Ciudad de M\u00e9xico, M\u00e9xico;"},{"name":"Latin American Neurosurgical Collaborative for Excellence in Research, Ciudad de M\u00e9xico, M\u00e9xico;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9sar Bigran","family":"Espinosa-Cant\u00fa","sequence":"additional","affiliation":[{"name":"Latin American Neurosurgical Collaborative for Excellence in Research, Ciudad de M\u00e9xico, M\u00e9xico;"},{"name":"School of Medicine, Universidad Aut\u00f3noma de Nuevo Le\u00f3n, Monterrey, Nuevo Le\u00f3n, M\u00e9xico;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alder Fernando","family":"Valenzuela-Rangel","sequence":"additional","affiliation":[{"name":"Latin American Neurosurgical Collaborative for Excellence in Research, Ciudad de M\u00e9xico, M\u00e9xico;"},{"name":"School of Medicine, Universidad Aut\u00f3noma de Baja California, Tijuana, Baja California, M\u00e9xico;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luz Camila","family":"Choque-Ayala","sequence":"additional","affiliation":[{"name":"Latin American Neurosurgical Collaborative for Excellence in Research, Ciudad de M\u00e9xico, M\u00e9xico;"},{"name":"School of Medicine, Facultad de Medicina, Universidad Cat\u00f3lica Boliviana San Pablo, Santa Cruz de la Sierra, Bolivia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aldo","family":"Barr\u00f3n-Lomel\u00ed","sequence":"additional","affiliation":[{"name":"Latin American Neurosurgical Collaborative for Excellence in Research, Ciudad de M\u00e9xico, M\u00e9xico;"},{"name":"Facultad de Medicina, Universidad Nacional Aut\u00f3noma de M\u00e9xico, Ciudad de M\u00e9xico, M\u00e9xico;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernesto A.","family":"Gutierrez-Herrera","sequence":"additional","affiliation":[{"name":"Latin American Neurosurgical Collaborative for Excellence in Research, Ciudad de M\u00e9xico, M\u00e9xico;"},{"name":"School of Medicine, Universidad Aut\u00f3noma de Baja California, Tijuana, Baja California, M\u00e9xico;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia Iliana","family":"Mej\u00eda P\u00e9rez","sequence":"additional","affiliation":[{"name":"Epilepsy Surgery Department, Instituto Nacional de Neurolog\u00eda y Neurocirug\u00eda \"Manuel Velasco Su\u00e1rez,\" Ciudad de M\u00e9xico, M\u00e9xico;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pavel S.","family":"Pichardo-Rojas","sequence":"additional","affiliation":[{"name":"Latin American Neurosurgical Collaborative for Excellence in Research, Ciudad de M\u00e9xico, M\u00e9xico;"},{"name":"The Vivian L. Smith Department of Neurosurgery, The University of Texas Health Science Center at Houston McGovern Medical School, Houston, Texas;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"Milanese","sequence":"additional","affiliation":[{"name":"Latin American Neurosurgical Collaborative for Excellence in Research, Ciudad de M\u00e9xico, M\u00e9xico;"},{"name":"Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo","family":"Rangel-Castilla","sequence":"additional","affiliation":[{"name":"Latin American Neurosurgical Collaborative for Excellence in Research, Ciudad de M\u00e9xico, M\u00e9xico;"},{"name":"Department of Neurosurgery, Hospital Lomas International, San Luis Potos\u00ed, M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"6","key":"b1","series-title":"Semin Neurol","first-page":"617","article-title":"Epilepsy\u2014definition, classification, pathophysiology, and epidemiology","volume":"40","author":"Falco-Walter J","year":"2020","unstructured":"Falco-Walter J. 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