摘要
目的探讨幕下小脑上锁孔入路显微手术切除松果体区肿瘤的可行性和安全性。方法依据术前神经影像学检查结果,制定个体化手术方案．采用经幕下小脑上锁孔入路,显微手术切除病变7例。骨窗大小约2．0 cm×2．5 cm,上缘达横窦和窦汇下缘。结果7例中,胚生殖细胞瘤2例；松果体细胞瘤2例；松果体母细胞瘤1例；胶质瘤1例；胆脂瘤1例。术后均行MRI检查,肿瘤全切除6例,1例次全切除。并发术后小脑肿胀、脑积水1例,再次行手术减压；1例术后出现一过性缄默及凝视；无死亡、感染及术后出血病例。近期随访效果良好。结论应用幕下小脑上锁孔入路显微手术切除松果体区肿瘤不仅可取得满意的切除率,而且手术创伤小、疗效好。
Objective This study is to explore the infratentorial-supraeerebellar keyhole approach for microsurgical treatment of pineal region tumors and to evaluate its curative efficacy and safety. Methods According to hi-fi quality MRI images, individual operation schemes were designed. Microsurgical infratentorial-supracerebellar keyhole approach was used to resect lesions in 7 consecutive patients with prone postition. A 2. 0cm×2. 5 cm surgical bone window was performed with its superior margin reaching to the inferior margin of the transverse sinus and confluence sinus. Results Among the 7 pineal region tumors, there were 2 germinomas, 2 pineocytomas, 1 pineoblastoma, 1 glioma and 1 chlesteatoma. All cases were re-examined with MRI after operation and it was found that 6 lesions were totally removed and 1 was subtotally removed. The outcome of the treatment was satisfying. There was no infection, bleeding or death after surgery. The follow-up result in the near future was good. Conclusion The infratentorial-supracerebellar keyhole approach for the excision of pineal region tumors was proved to be a satisfactory means with a total removal rate, an excellent curative effect and small surgical trauma.
出处
《中华显微外科杂志》
CSCD
北大核心
2006年第3期189-191,共3页
Chinese Journal of Microsurgery
基金
江苏省科技厅基金(BS2002017)
关键词
松果体区肿瘤
幕下小脑上入路
锁孔入路
显微外科
Pineal region tumors
Infratentorial-supracerebellar approach
Keyhole approach
Microsurgery
