小骨窗前纵裂入路显微手术切除巨大颅咽管瘤(17例报告)

目的评价小骨窗前纵裂入路在颅咽管瘤手术中的应用价值及并发症。方法经小骨窗前纵裂入路切除巨大颅咽管瘤17例,对手术技术及结果进行总结。结果本组全切除15例、近全切除2例,无手术死亡病例。由于术中直视下处理肿瘤在垂体漏斗部位的粘连,可较好保护垂体柄、下丘脑结构及局部穿支血管,13例患者超过2年的随访未见肿瘤复发及再生长。结论经小骨窗前纵裂入路可直视下处理肿瘤鞍内、鞍上及三脑室前部分,是鞍上生长位置较高的大型颅咽管瘤安全有效的手术入路之一。

Radical resection of large craniopharyngiomas by using the frontobasal interhemispheric approach ( Report of 17 cases)

Objective To establish the usefulness of the frontobasal approach made through a relatively small craniotomy window for the removal of large craniopharyngiomas. Methods 17 patients who were surgically treated for craniopharyngiomas by using a frontobasal approach made through a relatively small craniotomy window were evaluated.Results Total removal of the lesion was achieved in 15 cases, two patients underwent subtotal resection, None of the patients died during follow up; Via this approach, tumors can be removed without significant sequelae related to the surgical method, due to ease of preservation of the pituitary stalk, hypothalamic structures, and perforating vessels. Thirteen patients were followed up for at least 2 years, none of them suffered from tumor recurrence or regrowth.Conclusions The authors conclude that the frontobasal interhemispheric approach, even made through a small craniotomy window, offers a safe and minimally invasive means of treating large craniopharyngiomas.