视交叉-下丘脑胶质瘤的临床分型及手术治疗

目的　提高视交叉 下丘脑胶质瘤显微手术治疗水平。方法　回顾性分析 16例视交叉 下丘脑胶质瘤的影像学、手术资料及疗效。结果　本组全切除 6例 ,次全切除 4例 ,大部分切除 4例 ;根据肿瘤累及部位 ,视交叉 下丘脑胶质瘤可以分为 5型 :单纯视交叉型、视交叉 视神经型、视交叉 垂体柄型、视交叉 下丘脑型和弥散型 ,各型肿瘤在临床表现及手术学特点方面有所不同。 14例经过 2个月～ 5年的随访 ,除 1例再次手术后死亡其余均存活。结论　根据肿瘤累及部位 ,采用合适的手术技巧积极行显微手术切除 ,术后辅以放射治疗可以使大多数视交叉 下丘脑胶质瘤患者获得长期存活。

Clinical classfication and microsurgical treatment of chiasmatic-hypothalamic glioma

Objective To improve the microsurgical techniques for chiasmatic-hypothalamic glioma. Methods The imaging features, intraoperative course, and postoperative outcomes of 16 patients operated on for chiamatic-hypothalamic glioma were reviewed. Results Total, subtotal and partial removal of tumors were achieved in 6,4,4 cases respectively. According to the growth pattern, the chiasmatic-hypothalamic glioma can be divided into five types: pure chiasmal, chiasmo-optic nerve, chiasmo-stalk, chiasmo-hypothalamus, and difuse. 14 patients were followed for 2 months to 5 years. All the patients survived except one who died after second operation in other institution. Conclusions Our data suggest that with aggressive microsurgery depending on the growth pattern, and skillful microsurgical techniques in mandatary, combined with postoperative radiosurgery, the long term survival of patient with chiasmatic-hypothalamic glioma can be achieved in most patients.