经胼胝体-穹隆间入路切除第三脑室肿瘤  

Resection of third ventricle tumors via transcallosal interforniceal approach

作　　者：赵兴利[1] 韦博[1] 李朝晖[1] 苗壮[1] 索新[1] 戚宪国 

机构地区：[1]吉林大学中日联谊医院神经外科,吉林长春130031 [2]吉林市医院神经外科,吉林吉林132001

出　　处：《中国微侵袭神经外科杂志》2009年第10期445-447,共3页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的探讨经胼胝体-穹隆间入路显微手术切除第三脑室肿瘤的经验。方法经胼胝体-穹隆间入路切除第三脑室肿瘤24例,其中第三脑室前部肿瘤10例,中部12例,后部2例。结果肿瘤全切20例,近全切除3例,大部分切除1例。病理结果示:颅咽管瘤9例,胶样囊肿7例,星形细胞瘤4例,室管膜瘤2例,胶质母细胞瘤1例,畸胎瘤1例。术后并发症:近记忆力障碍6例,2个月内均有所恢复;短暂性尿崩5例,治疗1～2周后恢复;缄默症2例,1个月内恢复;脑积水4例,其中3例行脑室-腹腔分流术后恢复良好,另1例术前昏迷者,术后意识状态无改善,放弃治疗。结论经胼胝体-穹隆间入路切除第三脑室前、中部肿瘤是较理想的手术入路,肿瘤切除率高,病人术后合并症少、病死率低。Objective To explore t he microsurgical skills for third ventricle tumors via transcallosal interforniceal approach.Methods Twenty four patients with third ventricle tumors,10 out of them being located in the anterior portion of the third ventricle,12 in the middle portion and 2 in the posterior portion,underwent tumor resection via transcallosal interforniceal approach.Results Total resection of third ventricle tumors was achieved in 20 cases,subtotal resection in 3 and partial resection in 1.The pathological examination revealed 9 craniopharyngiomas,7 colloid cysts,4 astrocytomas,2 ependymocytomas,1 glioblastoma and 1 teratoma.Postoperative short-term memory disturbance occurred and recovered within 2 months in 6 patients.Transient diabetes insipidus was seen in 5 patients and the symptoms disappeared after treatment for 1-2 weeks.Mutism appeared and recovered in one month in 2 patients.Four patients had hydrocephalus,3 out of them underwent ventriculoperitoneal shunt with good recovery,and the treatment was given up in the other one because of no improvement of preoperative coma.Conclusion The transcallosal interforniceal approach is an ideal choice for tumors locating at the anterior and middle portion of third ventricle because of the high resection rate,low postoperative complications and minimal mortality.

关 键 词：脑室肿瘤 第三脑室 经胼胝体-穹隆间入路 神经外科手术 

分 类 号：R739.41[医药卫生—肿瘤]