内镜辅助锁孔入路夹闭颅内动脉瘤的初步经验

目的 评价锁孔入路和内镜辅助显微神经外科应用在前组循环动脉瘤夹闭手术中的作用.方法 回顾性分析我科2001年1-12月期间采用内镜辅助锁孔入路夹闭手术治疗颅内动脉瘤12例，着重于动脉瘤的部位、大小、手术技巧、手术结果和并发症。结果尽管骨窗小，术中显露可提供足够的空间进行颅内操作，保护脑和其他重要结构。本组病人出院时恢复良好，没有与入路相关的术后并发症，术后脑血管造影复查显示动脉瘤均消失，载瘤动脉通畅。结论 锁孔入路结合内镜辅助显微外科技术和脑脊液引流，是有经验的神经外科医生用于治疗前循环动脉瘤安全和有效的方法。

Surgical experience of keyhole approaches with endoscope-assisted microsurgery to anterior circulation aneurysms

Objective Operative management of cerebral aneurysms remains a technically challenging problem in modern neurosurgery despite major advances in microsurgical techniques. The purpose of this study was to evaluate the action of keyhole approaches with endoscope-assisted microsurgery to anterior circulation aneurysms. Methods A respective analysis has been made of 12 patients with anterior circulation aneurysms operated through keyhole approaches with endoscope-assisted microsurgery from January to December in 2001. The technique is described in detail, and the emphasis put on aneurismal site, operative result and complications. Results Despite the small size of the craniotomy, the exploration allows enough room for intracranial manipulation with maximal protection of brain and other intracranial structure. The presented series of patients recovery very well post-operatively, did not have any approach-related complications, and showed aneurysm disappear and parent artery open in repeated angiography post-operatively. Conclusion In our experience, the keyhole approach together with endoscope-assisted microsurgery and CSF drainage is a safe and effective approach for an experienced neurosurgeon to use in the treatment of supratentorial aneurysms.