显微手术切除松果体区肿瘤(附34例报告)

目的 总结松果体区肿瘤显微手术切除的经验。方法 回顾34例松果体区肿瘤的临床资料和手术体会。结果 本组患者中生殖细胞瘤12例,畸胎瘤7例,胶质瘤5例,脑膜瘤4例,胆脂瘤、海绵状血管瘤各2例,松果体细胞瘤和异位垂体腺瘤各1例。所有患者均行手术切除肿瘤,采用枕部经小脑幕入路27例,幕下小脑上入路4例,侧脑室三角部入路2例,经胼胝体入路1例。肿瘤全切除28例,次全切除5例,部分切除1例。手术后无住院期内死亡者。结论 显微手术技术的提高显著降低了松果体区肿瘤直接手术切除的死亡率和并发症发生率,我们认为积极的显微外科手术治疗是松果体区肿瘤最佳的一线治疗手段。

Microsurgical removal of pineal tumor: Report of 34 cases

Objective To summzrize our experience in microsurgical removal of pineal tumor. Methods Retrospective re-view of the clinical data of 34 pineal region tumors was reported and our surgical experience presented. Results Our series con-sisted of 12 germinomas, 7 teratomas, 5 gliomas, 4 meningiomas, 2 cholestomas, 2 cavernous malformation, 1 pineocytoma and 1 ectopic pituitary adenoma. All patients undervvent surgery with initial purpose of total tumor removal. The approaches used were oc-cipital transtentorial approach in 27, infratentorial supracerebellar approach in 4, trans-ventricular approach in 2, and transcallosal approach in 1. Total, subtotal, partial removal of tumors were achieved in 28, 5,1, respectively. There was no postoperative mortality during hospitalization. Conclusions The improvement of microsurgical techniques has significantly lowered the mortality and morbidity associated with direct surgery for pineal region tumor. We believe that aggressive microsurgery is the best first-line management for pineal region tumor.