Stereotactic biopsies of ventricular lesions may be less safe and less accurate than biopsies of superficial lesions. Accordingly, endoscopic biopsies have been increasingly used for these lesions. Except for pineal tumors, the literature lacks clear, reliable comparisons of these two methods. All 1581 adults undergoing brain tumor biopsy from 2007 to 2018 were retrospectively assessed. We selected 119 patients with intraventricular or paraventricular lesions considered suitable for both stereotactic and endoscopic biopsies. A total of 85 stereotactic and 38 endoscopic biopsies were performed. Extra procedures, including endoscopic third ventriculostomy and tumor cyst aspiration, were performed simultaneously in 5 stereotactic and 35 endoscopic cases. In 9 cases (5 stereotactic, 4 endoscopic), the biopsies were nondiagnostic (samples were nondiagnostic or the results differed from those obtained from the resected lesions). Three people died: 2 (1 stereotactic, 1 endoscopic) from delayed intraventricular bleeding and 1 (stereotactic) from brain edema. No permanent morbidity occurred. In 6 cases (all stereotactic), additional surgery was required for hydrocephalus within the first month postbiopsy. Rates of nondiagnostic biopsies, serious complications, and additional operations were not significantly different between groups. Mortality was higher after biopsy of lesions involving the ventricles, compared with intracranial lesions in any location (2.4% vs 0.3%, p = 0.016). Rates of nondiagnostic biopsies and complications were similar after endoscopic or stereotactic biopsies. Ventricular area biopsies were associated with higher mortality than biopsies in any brain area.

心室病变的立体定向活检可能不如浅表病变的活检安全和准确。因此，内窥镜活检越来越多地用于这些病变。除了松果体肿瘤，文献缺乏对这两种方法的明确、可靠的比较。对 2007 年至 2018 年接受脑肿瘤活检的所有 1581 名成年人进行了回顾性评估。我们选择了 119 名脑室内或脑室旁病变被认为适合立体定向和内窥镜活检的患者。总共进行了 85 次立体定向和 38 次内窥镜活检。在 5 个立体定向和 35 个内窥镜病例中同时进行了额外的手术，包括内窥镜第三脑室造口术和肿瘤囊肿抽吸术。9例（立体定向5例，内窥镜4例），活检是非诊断性的（样本是非诊断性的或结果与从切除病灶获得的结果不同）。3 人死亡：2 人（1 人立体定向，1 人内窥镜）死于迟发性脑室内出血，1 人（立体定向）死于脑水肿。没有发生永久性发病。在 6 例（均为立体定向）中，在活检后的第一个月内需要额外手术治疗脑积水。非诊断性活检、严重并发症和额外手术的发生率在各组之间没有显着差异。与任何位置的颅内病变相比，脑室病变活检后死亡率更高（2.4% 对 0.3%，1 个内窥镜）来自延迟脑室内出血和 1 个（立体定向）来自脑水肿。没有发生永久性发病。在 6 例（均为立体定向）中，在活检后的第一个月内需要额外手术治疗脑积水。非诊断性活检、严重并发症和额外手术的发生率在各组之间没有显着差异。与任何位置的颅内病变相比，脑室病变活检后死亡率更高（2.4% 对 0.3%，1 个内窥镜）来自延迟脑室内出血和 1 个（立体定向）来自脑水肿。没有发生永久性发病。在 6 例（均为立体定向）中，在活检后的第一个月内需要额外手术治疗脑积水。非诊断性活检、严重并发症和额外手术的发生率在各组之间没有显着差异。与任何位置的颅内病变相比，脑室病变活检后死亡率更高（2.4% 对 0.3%，p  = 0.016）。内窥镜或立体定向活检后，非诊断性活检和并发症的发生率相似。心室区域活检的死亡率高于任何脑区活检。