经幕下小脑上入路切除儿童松果体区肿瘤的临床效果分析  

Clinical efficacy of infratentorial supracerebellar approach for resecting pineal tumors in children

作　　者：沈志鹏[1] 张文博 石武杰 翁建彬 章培良 林超[1] 王宁[1] Shen Zhipeng;Zhang Wenbo;Shi Wujie;Weng Jianbin;Zhang Peiliang;Lin Chao;Wang Ning(Department of Neurosurgery,Children's Hospital,Zhejiang University School of Medicine,National Clinical Research Center for Child Health,Hangzhou 310052,China)

机构地区：[1]浙江大学医学院附属儿童医院神经外科,国家区域性儿童医疗中心,浙江省杭州市310052

出　　处：《临床小儿外科杂志》2021年第5期420-424,共5页Journal of Clinical Pediatric Surgery

基　　金：浙江省医药卫生科技计划项目(编号:JSW2013-A017)。

摘　　要：目的探讨经幕下小脑上入路手术治疗儿童松果体区肿瘤的效果,并分析其临床预后。方法以浙江大学医学院附属儿童医院2015年1月至2020年1月神经外科收治的35例在解剖学特征上适合接受经幕下小脑上入路手术治疗的儿童松果体区肿瘤患者(年龄≤18岁)作为研究对象,根据患者的基线数据和术后生存情况对该术式的临床疗效进行分析。结果35例中纯生殖细胞瘤13例,畸胎瘤10例,松果体母细胞瘤6例,混合性肿瘤2例,非典型畸胎样/横纹肌样肉瘤2例,星型细胞瘤1例,内胚窦瘤1例。肿瘤全切28例(80.0%),次全切5例(14.3%),活检2例(5.7%)。随访过程中4例死亡(11.4%),2例术后复发(5.7%)。结论儿童松果体区肿瘤以生殖细胞瘤和畸胎瘤多见,经幕下小脑上入路手术切除有较高的全切率,且大多数患者具有较高的长期生存率。Objective To explore the surgical efficacy and outcomes of infratentorial supracerebellar approach for pineal tumors in children.Methods From January 2015 to January 2020,a total of 35 children aged under≤18 years with pineal tumors anatomically suitable for infratentorial supracerebellar approach were enrolled.Retrospective analysis was performed for baseline data and postoperative survival.Results There were pure germinomas(n=13),teratomas(n=10),pinealblastoma(n=6),mixed tumors(n=2),atypical teratoid/rhabdoid tumor(n=2),astrocytoma(n=1)and yolk sac tumor(n=1).And the procedures included total tumor resection(n=28,80%),subtotal resection(n=5,14.3%)and biopsy(n=2,5.7%).By the end of follow-ups,there were death(n=4,11.4%)and postoperative recurrence(n=2,5.7%).Conclusion Most cases of pediatric pineal tumors are germinomas and teratomas.And infratentorial supracerebellar approach has a high resection rate and a high long-term survival rate.

关 键 词：松果体瘤/外科学 治疗结果 儿童 

分 类 号：R739.4[医药卫生—肿瘤] R726.1[医药卫生—临床医学]