侧裂区胶质瘤的显微手术治疗

背景与目的：脑胶质瘤手术切除程度与病人预后直接相关。但在某些部位,不易做到彻底切除,且易导致神经功能损害,本研究探讨侧裂区胶质瘤手术彻底切除的可能性以及肿瘤切除程度对术后神经功能的影响。方法：对22例侧裂区胶质瘤在显微镜下切除,大脑中动脉主要的分支血管予以保留,术后若出现神经功能障碍,根据可能的原因进行治疗。结果：全部端正例均在显微镜下行肿瘤全切除或次全切除。7例病人肿瘤切除后“桥状”保留通过瘤中心的功能血管。6例病人肿瘤切除术后出现肌力下降,其中5例半年后恢复,复查KPS70分以上。结论：侧裂区胶质瘤在显微镜下可以积极切除,术后多数病人不发生神经功能障碍,即使发生,其功能障碍大都能恢复。

Microneurosurgical treatment for gliomas located in lateral fissure area

BACKGROUND & OBJECTIVE: It has been generally recognized that extensive resection for gliomas is directly associated with better prognosis of the patients. However, some tumors in functional area are not easy to be radically resected and neurological deficiency could be resulted by surgery. This study was designed to investigate whether gliomas located in lateral fissure area could be radically resected without neurological deficiency. METHODS: There were 22 gliomas located in lateral fissure area underwent microsurgical resection. The main branches of middle cerebral artery were preserved and the patients, if any neurological disfunction occurrence, were treated accordingly. RESULTS: All 22 gliomas were totally or subtotally resected using microneurosurgical technique. In 7 cases the reserved functional vessels which pass through tumor mass, look like "bridge" after tumor resection. Six patients resulted in motor disfunction following surgery, in which 5 cases were recovered and KPS reached 70 after 6 months. CONCLUSION: Gliomas located in lateral fissure area could be radically resected under microscope resulting no neurological deficiency, if any, will recover.