完全神经内镜控制下切除小脑囊性血管母细胞瘤  

Resection of cerebellar cystic hemangioblastoma under total neuroendoscopic control

作　　者：高寒 李天栋 陈志生 陈志贺 谭绍涛 蓝锡昌 练石坤 王国良 Gao Han;Li Tiandong;Chen Zhisheng;Chen Zhihe;Tan Shaotao;Lan Xichang;Lian Shikun;Wang Guoliang(Department of Neurosurgery,Yunfu People's Hospital,Yunfu,Guangdong 527300,China;Department of Neurosurgery,General Hospital of the Southern Theatre Command,Guangzhou,Guangdong 510010,China)

机构地区：[1]云浮市人民医院神经外科,527300 [2]南部战区总医院神经外科,广州510010

出　　处：《中国微侵袭神经外科杂志》2020年第6期263-265,共3页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的探讨完全神经内镜控制下采用颅后窝锁孔开颅切除小脑囊性血管母细胞瘤的技术优势。方法回顾性分析5例小脑囊性血管母细胞瘤病例资料,共发现6个肿瘤结节,均采用后正中旁切口,单侧颅后窝锁孔开颅,在神经内镜完全控制下切除囊腔内肿瘤结节。其中4例术中准确快速发现与术前影像位置一致的肿瘤结节;1例除在术前影像引导下发现1个肿瘤结节外,经神经内镜探查还发现1个术前影像学漏诊的肿瘤结节。结果5例病人术后复查头部MRI均明确肿瘤结节全切除,囊腔有不同程度缩小。门诊随访1~5.5年,平均3.4年,病人均痊愈,未出现肿瘤复发。结论完全神经内镜控制下切除小脑半球的囊性血管母细胞瘤,手术创伤小、疗效佳,是处理该类型病变的较佳治疗选择。Objective To explore the technical advantages of keyhole craniotomy for cerebellar cystic hemangioblastoma in the posterior fossa under complete neuroendoscopic control.Methods The clinical data of 5 patients with cerebellar cystic hemangioblastoma,from whom a total of 6 tumor nodules were found,were analyzed retrospectively.The posterior paramedian incision was used,and the unilateral posterior cranial fossa keyhole craniotomy was used to remove the tumor nodules in the cyst cavity under the complete control of a neuroendoscope.The tumor nodules were accurately and quickly found at the same position as the preoperative image in 4 patietns.In addition,one tumor nodule was found under the guidance of preoperative imaging in 1 case,a tumor nodule missed by preoperative imaging was also found by neuroendoscopic exploration.Results Postoperative MRI confirmed total resection of the tumor nodules,and the cyst cavity was reduced to varying degrees in all the 5 patients.All the patients were followed up for 1 to 5.5 years,with an average of 3.4 years.There was no tumor recurrence.Conclusions Cerebellar cystic hemangioblastoma can be removed under the control of complete neuroendoscopy,with less surgical trauma and a good therapeutic outcome.The resection under neuroendoscopic control alone is the better treatment option for this type of lesion.

关 键 词：血管母细胞瘤 神经内镜 小脑 

分 类 号：R739.41[医药卫生—肿瘤]