岛叶胶质瘤的显微外科手术技巧

目的：探讨切除岛叶胶质瘤而又不伤及周边正常结构的显微手术技巧。方法：回顾性分析2003年5月到2008年8月在中南大学湘雅医院手术治疗的54例患者，经侧裂入路显微手术切除并经病理确诊的岛叶胶质瘤的术中技巧，总结术中重要血管的保护、周边正常结构的确认及保护。结果：本组经手术全切肿瘤36例，次全切14例，部分切除4例。术后出现暂时性语言功能障碍6例（失语多在术后10 d左右开始恢复），对侧肢体活动障碍加重4例（半年后3例恢复正常，1例好转），轻度偏瘫4例，偏瘫及语言功能障碍3例。结论：经侧裂入路的显微手术，可最大程度地暴露肿瘤与其周围结构的解剖关系，从而达到术中尽可能切除肿瘤而同时保护周边正常结构的目的。

Microsurgery techniques for insular glioma

ObjectiveTo explore the microsurgical techniques for insular glioma without damaging its surrounding normal structures.MethodsWe retrospectively analyzed 54 patients with insular gliomas who underwent microsurgical operation by trans-syvian fissure approach between May, 2003 and August, 2008 in Xiangya Hospital. We discussed the techniques in the operation and summarized how to protect the key blood vessels, distinguish and protect the surrounding normal structures. ResultsThere were 36 complete removals,14 secondary complete removals, and 4 partial removals.Six patients had complications after the craniotomy who had temporal speech disorder (aphasia mostly began to recover about 10 days after the craniotomy),4 patients had opposite side paralysis worsening (3 recovered normally and 1 improved after 6 months),4 had light paralysis, and another 3 had paralysis and speech disorder. ConclusionThe microsurgery by means of trans-syvian fissure approach can well expose the anatomical relation between tumor and its surrounding structures,so that we can remove the tumor and protect the surrounding normal tissues as much as we can.