前纵裂入路显微手术切除颅咽管瘤  

Microsurgery for craniopharyngioma via anterior interhemispheric approach

作　　者：计颖 牛朝诗 凌士营 鲍得俊 程伟 汪业汉 

机构地区：[1]安徽医科大学附属省立医院神经外科脑功能与脑疾病安徽省重点实验室,合肥230001

出　　处：《中国微侵袭神经外科杂志》2013年第5期207-209,共3页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的探讨前纵裂人路显微手术切除颅咽管瘤的方法和治疗效果。方法回顾性分析43例经前纵裂人路手术的颅咽管瘤病人的临床资料，其中复发颅咽管瘤2例。分析其术前评估、手术技巧和术后处理。结果肿瘤全切除30例，次全切除13例。垂体柄保留37例，切除6例。术后视力恢复或好转32例，无明显变化2例。术后并发症：多饮多尿9例，其中一过性尿崩症5例；电解质紊乱6例；颅内感染1例。本组无脑脊液漏及死亡病例。32例随访6。24个月，无肿瘤复发。结论经前纵裂人路能很好暴露手术视野，对脑组织损伤小，是手术切除中线生长的颅咽管瘤安全、有效的手术人路。但术前全面评估选择合适的手术入路也至关重要。Objective To investigate the method and therapeutic efficacy of microsurgery for craniopharyngioma via anterior intcrhcmispheric approach. Methods Clinical data of 43 patients with craniopharyngioma undergoing microsurgery via anterior interhemispheric approach were analyzed retrospectively, including 2 patients with recurrent craniopharyngioma. The preoperative assessment, surgical skill and postoperative treatment were analyzed. Results Total tumor resection was achieved in 30 patients and subtotal resection in 13. The pituitary stalk was reserved in 37 patients and removed in 6. Vision recovered or improved in 32 patients and no obviously changed in 2 after the operation. The main complications included polydipsia and polyuria in 9 patients （5 transient insipidus）, electrolyte disturbance in 6 and intracranial infection in 1. No cercbrospinal fluid leakage occurred and no patient died postoperatively. Thirty-two patients were followed up for 6 to 24 months, no tumor recurred. Conclusions Anterior interhemispheric approach can offer a very good exposure of the surgical field with minimum brain injury, and thus being a safe and effective approach for craniopharyngioma grown in the brain midline. However, selecting appropriate approach by preoperative assessment is also important.

关 键 词：颅咽管瘤 手术入路 前纵裂 显微外科手术 

分 类 号：R739.41[医药卫生—肿瘤] R651.11[医药卫生—临床医学]