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Peripheral Nerve Rapid Fire Abstract

Peripheral Nerve

Laparoscopic Management of Presacral Schwannomas: A Comprehensive Review and Meta-analysis of Individual Patient Data

Saturday, May 4, 2024
2:44 PM – 2:48 PM CT
Location:  S405a
Disclosure(s):
Filipi Fim Andreao: No financial relationships to disclose
Lucca B. Palavani: No financial relationships to disclose
MARCELO Porto Sousa: No financial relationships to disclose
Introduction: Presacral schwannomas are rare encapsulated nerve sheath tumors arising from the presacral space's nervous systems.The rising preference for minimally invasive procedures has made laparoscopic resection a favored approach.

Methods: We conducted a systematic search on laparoscopic resection of presacral schwannoma across multiple databases, adhering to the PRISMA guidelines. Studies were categorized based on the detail of patient data: the Individual Patient Data Meta-Analysis (IPDMA) group contained detailed patient-level data. Key outcomes included intraoperative and postoperative complications, like motor deficits and nerve injury, operative time, intraoperative bleeding and mortality.

Results: Out of 3394 articles sourced from prominent databases, including PubMed, Embase, Web of Science and the Cochrane Library, a total of 35 studies underwent thorough analysis comprising 87 patients were highlighted (59 non-IPDMA and 28 IPDMA). The rate of conversion from laparoscopic to open surgery was 0% ( 95% CI; 0% to 4%). In terms of complications, the analysis reported an incidence of 6%. (95% CI; 0% to 16%). Furthermore, our review found no instances of mortality, with a rate of 0% (95% CI; 0% to 4%). The mean operative time (non-IPDMA: mean 90 - 206 minutes; IPDMA: mean 161.50 ± 88.41 minutes) and surgical blood loss (non-IPDMA: mean 58.57 - 100 ml; IPDMA: mean 657.43 ± 2044.43 ml) were also analyzed.

Conclusion : The laparoscopic method for presacral schwannoma resection is safe, with low rate of complications, offering benefits like reduced surgical risks and improved postoperative outcomes. Our analysis supports its efficacy for these uncommon tumors. However, further research is needed to confirm long-term results.