神经内镜辅助锁孔入路显微手术治疗颅内前循环动脉瘤

目的探讨神经内镜辅助锁孔手术治疗颅内前循环动脉瘤的手术入路及显微手术技术。方法采用神经内镜辅助锁孔入路显微手术治疗颅内前循环动脉瘤41例。根据影像学诊断结果,制定个体化手术方案。手术经由头皮小切口,作直径约3cm的骨窗开颅,在充分释放脑脊液脑组织回缩后,从脑外间隙抵达深部病变;通过有序地解剖蛛网膜下腔,显露病变,行动脉瘤夹闭术。结果本组41次手术成功夹闭43个动脉瘤。无手术死亡及严重手术并发症。结论神经内镜辅助的锁孔入路较常规显微手术入路更为微创、精细、准确、安全,是夹闭颅内前循环动脉瘤的一种较好的技术。

Neuroendoscope-assisted Microsurgery through Keyhole Approach for Treatment of Intracranial Aneurysms of Anterior Circulation

Objective To explore the operative approach and technique of neuroendoscope-assisted microsurgery for the treatment of the intracranial aneurysms of anterior circulation. Methods Forty-one patients with intracranial aneurysms of anterior circulation were treated by neuroendoscope-assisted microsurgery through keyhole approach. According to the radiological imagings, the individual operation plan was worked out in 41 patients with intracranial aneurysms. A 3cm bone window in diameter was made through a small scalp incision. The deep lesion was reached through the gap between the skull and brain after the CSF was released and the cerebral tissue shrank. The aneurysms were noninvasively exposed and clipped by the endoscope-assisted microsurgical technique. Results The forty-three aneurysms in 41 patients were clipped by endoscope-assisted microsurgery technique. No one died and no severe postoperative complications occurred in all the patients. Conclusions The neuroendoscope-assisted microsurgery through the keyhole approach is more minimally invasive, more accurate, finer and safer than the routine microsurgery and is a valuable and better technique to treat the intracranial aneurysms of anterior circulation.