Evidence map›Paper›PMID 39680163›Full record

SynthesisChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2024

Open versus endoscopic surgery with helmet molding therapy in non-syndromic patients with craniosynostosis: an updated systematic review and meta-analysis of clinical outcomes and treatment-related costs.

Omar R Ortega-Ruiz, Mauricio Torres-Martínez, Mariana Villafranca-Cantú, Rebeca Alejandra Ávila-Cañedo, Emilio Piñeyro-Cantú, Eduardo Menchaca-Welsh, Nir Shimony, George I Jallo, Javier Terrazo-Lluch, J Javier Cuéllar-Hernández

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Postoperative raised ICP after minimally invasive surgery for monosutural craniosynostosis.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026
    Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Omar R Ortega-RuizTecnologico de Monterrey, Monterrey, Mexico. omarr.ortegaruiz@gmail.com.
Mauricio Torres-MartínezTecnologico de Monterrey, Monterrey, Mexico.
Mariana Villafranca-CantúTecnologico de Monterrey, Monterrey, Mexico.
Rebeca Alejandra Ávila-CañedoTecnologico de Monterrey, Monterrey, Mexico.
Emilio Piñeyro-CantúTecnologico de Monterrey, Monterrey, Mexico.
Eduardo Menchaca-WelshTecnologico de Monterrey, Monterrey, Mexico.
Nir ShimonyJohns Hopkins University, Baltimore, USA.
George I JalloJohns Hopkins All Children's Hospital, St. Petersburg, USA.
Javier Terrazo-LluchNational Institute of Pediatrics, Mexico City, Mexico.
J Javier Cuéllar-HernándezHospital Zambrano Hellion, San Pedro Garza García, Nuevo León, Mexico. javier.cuellar@tecsalud.mx.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThere is an ongoing debate regarding the optimal treatment for craniosynostosis as diverse factors influence the election between endoscopic and open surgery. Previous evidence favors endoscopic procedures. However, evidence remains unfulfilled by a limited number of patients and clustered in very few centers worldwide making it difficult to define it as a replicable technique in different populations. In recent years, evidence regarding endoscopic-assisted procedures has gone through a considerable spurt showing an increased interest among surgeons globally showing optimal outcomes in different populations and centers. In this systematic review and meta-analysis, we performed an updated analysis of previous reviews, including only non-syndromic patients. We also seek to provide a summary of the tendency of treatment observed in the literature. Similarly, this is the first study to include total costs within its analysis. MATERIAL AND

methodsThree previous meta-analyses published in 2018 yielded 11 eligible papers. We performed a systematic review and meta-analysis of the literature in MEDLINE and EMBASE databases through PubMed, Scopus, and Ovid to fill the gap of information between 2018 and 2024. Twenty-three total articles were included in the final analysis.

resultsVariables analyzed were baseline characteristics, length of stay, blood loss, transfusion rates and volume, operative time, and costs. The analysis of data concluded a younger age at surgery in patients undergoing endoscopic surgery (p ≤0.00001). Blood loss, transfusion rates, and volumes depicted favored outcomes for endoscopy with less blood loss during surgery (p ≤0.00001), operative time (p ≤0.00001), and transfusion rates (p ≤0.00001) as well as lower transfused volumes (p ≤0.00001).

conclusionEndoscopic surgery carries fewer complications than open surgery. Treatment-related costs are highly decreased in endoscopic procedures after including costs related to outpatient care. Open surgery can be considered in older children if no endoscope or experienced surgeons in endoscopic procedures are available.

Indexed as

CraniosynostosesEndoscopyHead Protective DevicesHumansNeuroendoscopyTreatment OutcomeCraniosynostosisEndoscopic surgeryNon-syndromic craniosynostosisOpen surgeryPediatrics

Identifiers

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.