Non-Cochrane · intervention · PM42769674
Comparison of selective amygdalohippocampectomy and anterior temporal lobectomy for mesial temporal lobe epilepsy: a systematic review and meta-analysis.
Barone Vinícius, Pires de Aguiar Paulo Henrique · Epilepsy & behavior reports · 2026 · PubMed · doi:10.1016/j.ebr.2026.100869
Findings
Population Patients with mesial temporal lobe epilepsy
10 findings
| Selective amygdalohippocampectomy | Anterior temporal lobectomy | Poor seizure outcome (Engel III–IV) 1 year · Random effects model | RR 1.28 [0.98, 1.69] GRADE not reported 14 studies · 1878 participants |
| Selective amygdalohippocampectomy | Anterior temporal lobectomy | Visual field defects on Goldmann perimetry Postoperative; variable follow-up · Common effect model | RR 0.85 [0.73, 0.99] GRADE not reported 3 studies · 634 participants |
| Selective amygdalohippocampectomy | Anterior temporal lobectomy | Visual field defects on Goldmann perimetry Postoperative; variable follow-up · Random effects model | RR 0.84 [0.78, 0.92] GRADE not reported 3 studies · 634 participants |
| Selective amygdalohippocampectomy | Anterior temporal lobectomy | Postoperative complications Postoperative; variable follow-up · Random effects model | RR 0.60 [0.30, 1.23] GRADE not reported 4 studies · 928 participants |
| Selective amygdalohippocampectomy | Anterior temporal lobectomy | Seizure freedom (Engel I) 1 year where available · Random effects model | RR 0.96 [0.89, 1.02] GRADE not reported 19 studies · 2235 participants |
| Selective amygdalohippocampectomy | Anterior temporal lobectomy | Postoperative complications Postoperative; variable follow-up · Common effect model | RR 0.62 [0.47, 0.83] GRADE not reported 4 studies · 928 participants |
| Selective amygdalohippocampectomy | Anterior temporal lobectomy | Decline in verbal memory performance (RAVLT) Postoperative; variable follow-up · Random effects model | RR 0.80 [0.39, 1.63] GRADE not reported 5 studies · 875 participants |
| Selective amygdalohippocampectomy | Anterior temporal lobectomy | Seizure freedom (Engel I) 1 year where available · Common effect model | RR 0.92 [0.87, 0.97] GRADE not reported 19 studies · 2235 participants |
| Selective amygdalohippocampectomy | Anterior temporal lobectomy | Decline in verbal memory performance (RAVLT) Postoperative; variable follow-up · Common effect model | RR 0.76 [0.59, 0.99] GRADE not reported 5 studies · 875 participants |
| Selective amygdalohippocampectomy | Anterior temporal lobectomy | Poor seizure outcome (Engel III–IV) 1 year · Common effect model | RR 1.22 [1.00, 1.50] GRADE not reported 14 studies · 1878 participants |
Included primary studies 22
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Almeida 2023 Surgical treatment of temporal lobe epilepsy: comparative results of selective amygdalohippocampectomy versus anterior temporal lobectomy… PMID:37494949 | 2023 | this review only | not stated | not extracted yet |
| Arruda 1995 Mesial atrophy and outcome after amygdalohippocampectomy or temporal lobe removal. PMID:8797534 | 1996 | this review only | Seizure freedom (Engel I) | not extracted yet |
| Bate 2006 The seizure outcome after amygdalohippocampectomy and temporal lobectomy. PMID:17222120 | 2007 | this review only | not stated | not extracted yet |
| Boucher 2015 Different effects of anterior temporal lobectomy and selective amygdalohippocampectomy on verbal memory performance of patients with… PMID:26469799 | 2015 | this review only | not stated | not extracted yet |
| Bujarski 2013 Long-term seizure, cognitive, and psychiatric outcome following trans-middle temporal gyrus amygdalohippocampectomy and standard temporal… PMID:23621601 | 2013 | this review only | Seizure freedom (Engel I) | not extracted yet |
| Clusmann 2002 Prognostic factors and outcome after different types of resection for temporal lobe epilepsy. PMID:12450036 | 2002 | this review only | not stated | not extracted yet |
| Egan 2000 Visual field deficits in conventional anterior temporal lobectomy versus amygdalohippocampectomy. PMID:11134379 | 2000 | this review only | Visual field defects on Goldmann perimetry | not extracted yet |
| Elliott 2018 Seizure outcome in pediatric medically refractory temporal lobe epilepsy surgery: selective amygdalohippocampectomy versus anterior… PMID:29932370 | 2018 | this review only | not stated | not extracted yet |
| Lee 1997 Effects of left temporal lobectomy and amygdalohippocampectomy on memory. PMID:18638976 | 1997 | this review only | not stated | not extracted yet |
| Mathon 2017 Complications After Surgery for Mesial Temporal Lobe Epilepsy Associated with Hippocampal Sclerosis. PMID:28389411 | 2017 | this review only | not stated | not extracted yet |
| Mittal 2005 Long-term outcome after surgical treatment of temporal lobe epilepsy in children. PMID:16302611 | 2005 | this review only | Seizure freedom (Engel I) | not extracted yet |
| Morino 2006 Comparison of neuropsychological outcomes after selective amygdalohippocampectomy versus anterior temporal lobectomy. PMID:16716754 | 2006 | this review only | Seizure freedom (Engel I) | not extracted yet |
| Nascimento 2015 Anterior temporal lobectomy versus selective amygdalohippocampectomy in patients with mesial temporal lobe epilepsy. PMID:26690840 | 2016 | this review only | not stated | not extracted yet |
| Paglioli 2006 Seizure and memory outcome following temporal lobe surgery: selective compared with nonselective approaches for hippocampal sclerosis. PMID:16509149 | 2006 | this review only | not stated | not extracted yet |
| Sagher 2012 Seizure outcomes and mesial resection volumes following selective amygdalohippocampectomy and temporal lobectomy. PMID:22380862 | 2012 | this review only | not stated | not extracted yet |
| Schijns 2011 Presence of temporal gray-white matter abnormalities does not influence epilepsy surgery outcome in temporal lobe epilepsy with… PMID:21150756 | 2011 | this review only | not stated | not extracted yet |
| Schmeiser (2) 2017 Visual field defects following different resective procedures for mesiotemporal lobe epilepsy. PMID:28954709 | 2017 | this review only | Visual field defects on Goldmann perimetry | not extracted yet |
| Schmeiser 2017 Surgical Treatment of Mesiotemporal Lobe Epilepsy: Which Approach is Favorable? PMID:28582572 | 2017 | this review only | not stated | not extracted yet |
| Tanriverdi 2008 Long-term seizure outcome after mesial temporal lobe epilepsy surgery: corticalamygdalohippocampectomy versus selective… PMID:18312099 | 2008 | this review only | not stated | not extracted yet |
| Tanriverdi 2010 Memory outcome after temporal lobe epilepsy surgery: corticoamygdalohippocampectomy versus selective amygdalohippocampectomy. PMID:19961307 | 2010 | this review only | not stated | not extracted yet |
| Wang 2018 Clinical outcomes after medial temporal lobe epilepsy surgery: Anterior temporal lobectomy versus selective amygdalohippocampectomy. PMID:30110006 | 2018 | this review only | not stated | not extracted yet |
| Wendling 2013 Selective amygdalohippocampectomy versus standard temporal lobectomy in patients with mesial temporal lobe epilepsy and unilateral… PMID:23022178 | 2013 | this review only | Seizure freedom (Engel I) | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients with mesial temporal lobe epilepsy (drug-resistant) | Patients with MTLE (n=2,482; 1,275 ATL and 1,207 SAH) |
| Intervention | Selective amygdalohippocampectomy | SAH, transsylvian or transcortical (n=22 studies) |
| Comparison | Anterior temporal lobectomy | ATL, standard anteromesial resection (n=22 studies) |
| Outcomes | Seizure freedom (Engel I, primary); Engel III-IV outcome; neuropsychological performance; postoperative complications; visual field defects (Goldmann) | Seizure freedom (n=19); Engel III-IV (n=14); RAVLT verbal memory decline (n=5); postoperative complications (n=4); Goldmann visual field defects (n=3) |
| Study designs | Randomized or non-randomized comparative cohort studies; no language or date limits | Retrospective and prospective cohort studies; no RCTs (n=22) |
| Timing | Seizure outcomes at 1 year (longest available if < 1 year); other outcomes as reported | Mean follow-up 12 months to 10 years; seizure outcomes at 1 year |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | No | No | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | No | no |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | No | Yes | no |
| 9Risk of bias assessed satisfactorilycritical | RCT: N/A · NRSI: Yes | RCT: N/A · NRSI: Yes | yes |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: N/A · NRSI: No | RCT: N/A · NRSI: No | yes |
| 12Impact of risk of bias on the pooled results | No | Yes | no |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |