Relation between Resection Extent and Intraoperative Hemorrhage and External Ventricular Drain Insertion in Lateral Ventricular Tumors

Background: Lateral ventricular tumors are rare, deep-seated lesions often surrounded by vital neurovascular structures, making surgical resection challenging. The extent of resection significantly impacts intraoperative events such as hemorrhage and the need for external ventricular drain (EVD) placement. Objective: To evaluate the relation between the extent of tumor resection and intraoperative hemorrhage and EVD insertion in lateral ventricular tumors. Patients and Methods: This retrospective study was conducted on 45 patients with lateral ventricular tumors treated surgically at Suez Canal University Hospitals and Nasser Institute Hospital. Resection extent (total, sub-total, or biopsy) was related with intraoperative hemorrhage and EVD placement. Results: Total resection was achieved in 48.9%, sub-total resection in 31.1%, and biopsy in 20% of cases. Intraoperative hemorrhage occurred significantly more in total resections (36.4%) compared to sub-total resections and biopsies (0%, p=0.006). EVD insertion was significantly higher in total (72.7%) and sub-total resections (78.6%) compared to biopsies (22.2%, p=0.012). At surgery, Karnofsky Performance Scale (KPS) scores were significantly higher in total and sub-total resections (median 90, p=0.008) but showed no significant difference postoperatively (p=0.218). Conclusion: The extent of tumor resection relates with increased intraoperative hemorrhage and EVD insertion, highlighting the importance of careful surgical planning to balance resection extent and complication risks.