Brainstem hemangioblastomas are benign, highly vascular tumors located in the mesencephalon, pons, and medulla oblongata. Although surgical resection is currently considered the main therapeutic option for symptomatic lesions, evidence supporting the application of microsurgery has not been systematically assessed. This meta-analysis aims to evaluate the safety and efficacy of surgical treatment for brainstem hemangioblastomas. A comprehensive search of the PubMed, Embase, and Web of Science databases was performed to identify all English language publications reporting the outcomes of surgical treatment for brainstem hemangioblastomas. Studies from January 1990 to July 2019 with ≥ 10 cases were included. We analyzed the surgical outcomes, including gross total resection, mortality, neurological morbidity, and functional outcome according to the McCormick Scale or Karnofsky Performance Scale. Thirteen studies with 473 cases were included. The pooled proportion of gross total resection was 98% (95% confidence interval (CI), 94-100%). Overall mortality and neurological morbidity were 4 (95% CI, 2-6%) and 13% (95% CI, 7-20%), respectively. Favorable functional outcomes at the last follow-up were achieved in 85% (95% CI, 78-92%) of all patients. Improved or stable functional outcomes at long-term follow-up were achieved in 94% (95% CI, 89-97%) of patients. This meta-analysis revealed that surgical treatment for brainstem hemangioblastomas is technically feasible and effective with lasting patient benefits and cure.

中文翻译：

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脑干血管母细胞瘤手术治疗的安全性和有效性：荟萃分析。

脑干血管母细胞瘤是良性的、高度血管化的肿瘤，位于中脑、脑桥和延髓。虽然手术切除目前被认为是症状性病变的主要治疗选择，但尚未系统评估支持显微手术应用的证据。本荟萃分析旨在评估脑干血管母细胞瘤手术治疗的安全性和有效性。对 PubMed、Embase 和 Web of Science 数据库进行了全面搜索，以确定所有报告脑干血管母细胞瘤手术治疗结果的英文出版物。纳入1990年1月至2019年7月≥10例病例的研究。我们分析了手术结果，包括总切除术、死亡率、神经系统发病率、和功能结果根据麦考密克量表或卡诺夫斯基表现量表。共纳入 13 项研究，涉及 473 例病例。总切除术的合并比例为 98%（95% 置信区间 (CI)，94-100%）。总体死亡率和神经系统发病率分别为 4（95% CI，2-6%）和 13%（95% CI，7-20%）。85% (95% CI, 78-92%) 的所有患者在最后一次随访时获得了良好的功能结果。94% (95% CI, 89-97%) 的患者在长期随访中获得了改善或稳定的功能结果。这项荟萃分析表明，脑干血管母细胞瘤的手术治疗在技术上可行且有效，可对患者带来持久的益处和治愈。总切除术的合并比例为 98%（95% 置信区间 (CI)，94-100%）。总体死亡率和神经系统发病率分别为 4（95% CI，2-6%）和 13%（95% CI，7-20%）。85% (95% CI, 78-92%) 的所有患者在最后一次随访时获得了良好的功能结果。94% (95% CI, 89-97%) 的患者在长期随访中获得了改善或稳定的功能结果。这项荟萃分析表明，脑干血管母细胞瘤的手术治疗在技术上可行且有效，可对患者带来持久的益处和治愈。总切除术的合并比例为 98%（95% 置信区间 (CI)，94-100%）。总体死亡率和神经系统发病率分别为 4（95% CI，2-6%）和 13%（95% CI，7-20%）。85% (95% CI, 78-92%) 的所有患者在最后一次随访时获得了良好的功能结果。94% (95% CI, 89-97%) 的患者在长期随访中获得了改善或稳定的功能结果。这项荟萃分析表明，脑干血管母细胞瘤的手术治疗在技术上可行且有效，可对患者带来持久的益处和治愈。94% (95% CI, 89-97%) 的患者在长期随访中获得了改善或稳定的功能结果。这项荟萃分析表明，脑干血管母细胞瘤的手术治疗在技术上可行且有效，可对患者带来持久的益处和治愈。94% (95% CI, 89-97%) 的患者在长期随访中获得了改善或稳定的功能结果。这项荟萃分析表明，脑干血管母细胞瘤的手术治疗在技术上可行且有效，可对患者带来持久的益处和治愈。