脑胶质瘤全切术后复发根源及手术对策探讨

根据脑胶质瘤患者复发前后２次头颅ＣＴ影像及术中所见和对３４例首次全切后肿瘤复发部位、瘤结节部位及供血血管与肿瘤关系的特征进行分析发现，肿瘤复发根源主要集中在与原病灶相关的５个部位，即首次ＣＴ瘤周水肿区明显处（１２例）、皮层表面处（９例）、脑室壁（５例）、相邻大脑镰对侧（４例）和原肿瘤主要供血血管周（４例）。对其原因进行讨论并提出脑胶质瘤积极切除术概念及参考标准。

Research on Recurrence Origin of Gliomas after Total Resection and Surgical Countermeasure

Basing on before and after recurrence CT-image and the observation in operation,characterization of tumor recurrence location,tumoral node and relationship between blood-supply vessel and tumor in 34 patients with gliomas after the first time total resection were analysed.Five main locations which related to the primary foci are considered to be the recurrence origin of tumor:(1)the obvious CT-peritumoral edema area before recurrence(12 cases);(2)the cortex near focus(9 cases);(3)the ventriculowall(5cases);(4)the opposite side of falx cerebri near focus;(5)the surrounding area of main primary tumor blood-supply vessel.the mechanism of these characterizations were discussed and the concept and conference standard of aggressive surgery for brain gliomas were raised in this paper.