Comparison of Perioperative Costs between Stereotactic Laser Ablation and Craniotomy for Hypothalamic Hamartoma

Abstract

Hypothalamic hamartoma (HH) is a congenital intracranial lesion associated with precocious puberty and gelastic epilepsy in children. Surgical management of HH to treat refractory epilepsy is a mainstay of treatment. Our aim was to compare the demographic characteristics and perioperative costs associated with resection by craniotomy and stereotactic laser ablation (SLA) by reviewing our institutional experience with SLA and comparing these data to a national database for craniotomy and resection. Retrospective chart review was conducted for the Texas Children's Hospital cohort of patients who underwent SLA for HH between 2011 and 2013. Information about the craniotomy cohort representing historical cases of craniotomy was obtained from the Kids' Inpatient Database for years 2003, 2006, and 2009. The cohort definition for patients undergoing craniotomy for HH was modified from published adult literature to identify pediatric patients with refractory epilepsy secondary to HH. Our study has shown that children undergoing SLA for HH have a shorter length of stay and lower cost of hospitalization compared with those who underwent craniotomy and resection for the same diagnosis. Together with previous findings from our institution regarding the safety and efficacy of SLA, our findings suggest that SLA may represent an attractive alternative to craniotomy for the treatment of refractory epilepsy secondary to HH.