神经内镜及内镜辅助显微手术治疗颅内囊性病变

目的 :总结微侵袭内镜神经外科手术治疗颅内囊性病变的适应证、方法及其优缺点。方法 :应用神经内镜及内镜辅助显微神经外科手术治疗颅内囊性肿瘤、蛛网膜囊肿、脑室内囊肿、透明膈囊肿及脑脓肿共 4 5例。结果 :11例囊性肿瘤全切 7例、次全切除 4例 ,术后症状均明显改善或消失 ;18例蛛网膜囊肿全部行囊壁部分切除、囊肿 -脑池 /脑室造瘘 ,症状 (13/ 16例 )明显缓解或消失 ,2例缓解 ,1例无变化 ;3例脑室内囊肿均切除 ,症状均消失 ;10例透明膈囊肿全部行囊肿 -脑室造瘘 ,症状消失或明显改善 9例 ,1例无缓解 ;3例脑脓肿行囊肿引流 ,症状均消失。并发症共 7例 ,无伤残及死亡。结论 :神经内镜手术具有微创、安全、疗效好等优点 ,适用于囊性肿瘤、蛛网膜囊肿、脑室内囊肿、透明膈囊肿及脑脓肿等颅内囊性病变。

Neuroendoscope and Endoscope - assisted Microneurosurgery for Intracranial Cystic Lesions

Objective: To discuss the indications, techniques, adventages and disadventages of minimally invasive endoscopic neurosurgery for intracranial cystic lesions. Methods: There were 45 patients with intracranial cystic tumors,arachnoid cysts, intraventricular cysts, septum pellucidum cysts and brain abscess underwent endoscopic neurosurgery and endoscope-assisted microneurosurgery. Results: Seven patients underwent total resection and 4 patients underwent mostly resection in 11 patients with cystic tumors, all patients were symptom-free or markedly improved after the endoscopic operation. Eighteen patients with intracranial arachnoid cysts underwent cyst partial resection and cystocisternostomy, 13 in 16 patients were symptom-free or markedly improved and 2 patients were improved and 1 patient had no change.Three patients with intraventricle cysts underwent resection and were symptom-free. Ten patients with septum pellucidum cysts under went cystoventriculostomy, 9 were symptom-free or markedly improved and 1 had no change.Three patients with brain abscess were recovered.There were complications in 7 cases, mortality rate as well as morbidity rate were zero. Conclusion: Endoscopic neurosurgery can be recommended as minimally invasiveness, safe and reliable effect, and it adapt to intracranial cystic lesions such as intracranial cystic tumors, arachnoid cysts, intraventricular cysts, septum pellucidum cysts and brain abscess.