神经内镜辅助显微手术治疗囊性脑肿瘤的疗效观察

目的]总结显微直视手术颅内囊性肿瘤中辅以神经内镜处理显微镜死角区肿瘤的经验,以期提高颅内囊性肿瘤的全切率.方法]回顾性分析2003年8月-2010年8月手术治疗的颅内囊性肿瘤病例49例,所有病例术前均行影像学检查并经手术及病理证实.其中囊性脑胶质瘤21例,囊性脑膜瘤11例,囊性室管膜瘤4例,血管网织细胞瘤3例,囊性...

Treatment of cystic brain tumor with neuroendoscope-assisted microneurosurgery

Objective] To evaluate clinical practice of tumor resection at blind angle by microsurgery under direct vision combined with neuroendoscopy in order to improve the total resection rate of intracranial cystic tumor.Methods] A retrospective analysis of 49 patients with intracranial cystic tumors,which were confirmed by operation and pathological examination and treated by neuroendoscopic microsurgery from August 2003 to August 2010 was performed,in which there were 21 cases of cystic cerebral glioma,11 cases of cystic meningeoma,4 cases of cystic ependymoma,3 cases of angioreticuloma,6 cases of cystic brain metastasis tumor,and 4 cases of epidermoid cyst.Proper craniotomy was performed according to the position of lesions,and the tumor and cystic lesions were resected under direct vision.For comparison,51 cases with intracranial cystic tumor operations without neuroendoscopy from August 1996 to July 2003 were taken as the control group.Results] According to postoperative imaging,in the neuroendoscopic group there were 43 cases of total resection(87.76%),6 cases of mostly resection(12.24%),5 cases of neurologic dysfunction(10.20%).There was no death caused by operation.Thirty-eight cases were followed up for 0.5~6 years and they all returned to normal.While in the control group,there were 34 cases of total resection(66.67%),17 cases of mostly resection(33.33%),7 cases of neu-rologic dysfunction(13.73%) and 2 cases of death due to operation.There was difference between neuroendoscope-assisted and the control group in total removal rate(P<0.05),and the incidence of complications such as postoperative neurological dysfunction between the two groups had no difference(P>0.05).Conclusion] The residual tumor in blind area of intracranial cystic tumors could be totally resected by microsurgery under direct vision combined with neuroendoscopy with a higher total resection rate and a lower tumor recurrence rate.