158 Outcomes of Tubular Retractor Utilization for Cranial Tumor Resection: A Pediatric Case Series at Le Bonheur Children’s Hospital

INTRODUCTION: The tubular retractor system in neurosurgery has commonly been used as a minimally invasive approach for spinal surgeries. Recently studies have reported their use in adult and pediatric cranial tumor resection. In this study, we sought to analyze our experience and outcomes in pediatric cranial tumor resections using a tubular retractor system. METHODS: A retrospective study was conducted to identify and analyze all children who underwent resection of cranial tumors using a tubular retractor system. Perioperative data included patient demographics, pre-operative presentation, pathology details, extent of resection, post-operative complications, and long-term outcomes. RESULTS: 21 patients were identified (10 male, 11 female) with a mean age of 10.1 years (1 year – 24 years). Most patients (15, 71.4%) achieved gross-total resections; 3 (14.3%) were near-total; and 2 (9.5%) were biopsies. Of the 21 patients, six had only one immediate post-operative complication, while patients two had two immediate post-operative complications. These included six with muscle weakness, one with hypopituitarism, and two with visual deficits. In addition, the average estimated blood loss was 105 mL, and the average length of stay was 4.14 days. The 30- and 90-day readmission rates and number of re-do resections were zero. On follow-up, 20 regularly followed-up with no worsening of post-operative complications, while only one was lost to follow-up. CONCLUSIONS: The utilization of the tubular retractor system in pediatric cranial tumor resection surgery is an effective retraction technique to decrease both strain on the brain and blood loss depending on the location of the pathology. In addition, it has practical application in possibly achieving higher rates of gross-total resection, avoiding post-operative complications, decreasing readmission rates, and preventing re-do resection surgeries.