[1]陈　军　赵一清　唐思成　郑一枫　王　煜.经胼胝体-透明隔-穹窿间入路显微手术切除第三脑室内颅咽管瘤的疗效分析[J].中国临床神经外科杂志,2018,(06):395-397401.[doi:10.13798/j.issn.1009-153X.2018.06.004]
　CHEN Jun,ZHAO Yi-qing,TANG Si-cheng,et al.Curative effect of microsurgery via transcallosal-septum pellucidum-interforniceal approach on craniopharyngiomas in the third ventricles[J].,2018,(06):395-397401.[doi:10.13798/j.issn.1009-153X.2018.06.004]
点击复制

经胼胝体-透明隔-穹窿间入路显微手术切除第三脑室内颅咽管瘤的疗效分析()
分享到：

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2018年06期
页码:
395-397401
栏目:
论著
出版日期:
2018-06-25

文章信息/Info

Title:
Curative effect of microsurgery via transcallosal-septum pellucidum-interforniceal approach on craniopharyngiomas in the third ventricles
文章编号:
1009-153X（2018）06-0395-03
作者:
陈　军　赵一清　唐思成　郑一枫　王　煜
作者单位：430030 武汉，华中科技大学同济医学院附属同济医院神经外科（陈　军、赵一清、唐思成、郑一枫、王　煜）
Author(s):
CHEN Jun;  ZHAO Yi-qing;  TANG Si-cheng;  ZHENG Yi-feng;  WANG Yu.
Department of Neurosurgery, Tongji Hospital, Tongji Medical School, Huazhong University of Sciences and Technology, Wuhan 430030, China
关键词:
颅咽管瘤; 第三脑室; 显微手术; 胼胝体-透明隔-穹隆间入路; 疗效
Keywords:
Craniopharyngiomas;  Microsurgery;  Transcallosal-septum pellucidum-interforniceal approach;  Third ventricles;  Curative effect
分类号:
R 739.41; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2018.06.004
文献标志码:
A
摘要:
目的 探讨经胼胝体-透明隔-穹窿间入路显微手术切除第三脑室内颅咽管瘤的疗效。方法 回顾性分析2011年2月至2017年9月经胼胝体-透明隔-穹窿间入路显微手术切除的17例第三脑室内颅咽管瘤的临床资料，术前均行对侧侧脑室外引流术。结果 肿瘤全切除14例 ，次全切除2例，部分切除1例。术后出现尿崩症8例，电解质紊乱14例，癫痫1例，高热1例，短期记忆力减退4例。术后长期昏迷1例，死亡1例；15例康复出院。13例术后随访3个月~6年，肿瘤复发2例。结论 经胼胝体-透明隔-穹窿间入路为切除第三脑室内颅咽管瘤的有效途径；术前行脑室外引流术有助于减轻脑积水及减少术后并发症。
Abstract:
Objective To investigate the curative effect of microsurgery via transcallosal-septum pellucidum-interforniceal approach on craniopharyngiomas in the third ventricles. Methods The clinical data of 17 patients with craniopharyngiomas in the third ventricles, who underwent preoperative external ventricular drainage and microsurgery via transcallosal-septum pellucidum- interforniceal approach for the tumors in our hospital from February, 2011 to September, 2017, were analyzed retrospectively. Results The total resection of the tumors was achieved in 14 cases, subtotal resection in 2 and partial resection in 1 case. There were diabetes insipidus in 8 patients, electrolyte disturbance in14, epilepsy in 1, hyperpyrexia in 1, short-term memory loss in 4 and coma in 1, and 1 patient died after the microsurgery. Following-up ranging from 3 months to 6 years after the surgery showed that the tumors recurred in 2 patients. Conclusions The transcallosal-septum pellucidum-interforniceal approach is one effective surgical approach for craniopharyngiomas in the third ventricles. The preoperative external intraventricular drainage is helpful to decrease in the hydrocephalus and postoperative complications.

参考文献/References:

[1] Mortini P, Losa M, Pozzobon G, et al. Neurosurgical treat- ment of craniopharyngioma in adults and children: early and long-term results in a large case series [J]. J Neuro- surg, 2011, 114(5): 1350-1359.
[2] Karavitaki N, Brufani C, Warner JT, et al. Craniopharyngi- omas in children and adults: systematic analysis of 121 cases with long-term follow-up [J]. Clin Endocrinol (Oxf), 2005, 62(4): 397-409.
[3] Hoffman HJ. Surgical management of craniopharyngioma [J]. Pediatr Neurosurg, 1994, 21 Suppl 1: 44-49.
[4] Yasargil MG, Curcic M, Kis M, et al. Total removal of cra- niopharyngiomas: approaches and long-term results in 144 patients [J]. J Neurosurg, 1990, 73(1): 3-11.
[5] Zuccaro G. Radical resection of craniopharyngioma [J]. Childs Nerv Syst, 2005, 21(8-9): 679-690.
[6] Im SH, Wang KC, Kim SK, et al. Transsphenoidal micro- surgery for pediatric craniopharyngioma: special considera- tions regarding indications and method [J]. Pediatr Neuro- surg, 2003, 39(2): 97-103.
[7] Reyes OF. Craniopharyngioma: recurrence [J]. An R Acad Nac Med (Madr), 2001, 118(2): 263-274.
[8] Nishimoto A, Matsuhisa T, Kunishio K, et al. Craniopharyn- gioma: early and long term recurrence after partial removal [J]. J Neurol Neurosurg Psychiatry, 1995, 58(1): 111-112.
[9] Jia W, Ma Z, Liu IY, et al. Transcallosal interforniceal approach to pineal region tumors in 150 children [J]. J Neurosurg Pediatr, 2011, 7(1): 98-103.
[10] 张宏伟，张明山，夏　雷，等. 经胼胝体-穹窿间入路切除 第三脑室内部及其后部肿瘤的临床治疗探讨 [J]. 中华外 科杂志，2012，50（2）：139-143.
[11] Winkler PA, Ilmberger J, Krishnan KG, et al. Transcallosal interforniceal-transforaminal approach for removing lesions occupying the third ventricular space: clinical and neuro- psychological results [J]. Neurosurgery, 2000, 46: 879-890.
[12] Winkler PA, Weis S, Buttner A, et al. The transcallosal interforniceal approach to the third ventricle: anatomic and microsurgical aspects [J]. Neurosurgery, 1997, 40: 973-982.
[13] 马振宇，张玉琪，罗世琪. 经胼胝体-穹窿间入路切除儿 童第三脑室肿瘤[J]. 中华神经外科杂志，2000，16（4）： 10-12.

相似文献/References:

[1]葛怡宁　幸　兵　姚　勇　邓　侃　王任直.颅咽管瘤合并毛细胞星形细胞瘤1例[J].中国临床神经外科杂志,2016,(05):319.[doi:10.13798/j.issn.1009-153X.2016.05.023]
[2]王洪伟　张剑宁　于　新　王亚明　李海龙　韩铖琛　杨　帆.颅咽管瘤的个体化治疗分析[J].中国临床神经外科杂志,2016,(03):141.[doi:10.13798/j.issn.1009-153X.2016.03.003]
　WANG Hong-wei,ZHANG Jian-ning,YU Xin,et al.Individualized treatment for craniopharyngiomas and analyses of typical cases[J].,2016,(06):141.[doi:10.13798/j.issn.1009-153X.2016.03.003]
[3]程 荆　江普查　曹长军　李登辉　黄　充　游　金　兰　静.颅咽管瘤显微手术的疗效分析[J].中国临床神经外科杂志,2016,(01):1.[doi:10.13798/j.issn.1009-153X.2016.01.001]
　CHENG Jing,JIANG Pu-cha,CAO Chang-jun,et al.Analysis of curative effect of microsurgery on craniopharyngiomas (report of 126 cases)[J].,2016,(06):1.[doi:10.13798/j.issn.1009-153X.2016.01.001]
[4]项　炜　何运松　朱贤立　赵洪洋　张方成　林　洪　林　宁　林敏华.216例颅咽管瘤的显微手术治疗[J].中国临床神经外科杂志,2015,(04):205.[doi:10.13798/j.issn.1009-153X.2015.04.004]
　XIANG Wei,HE Yun-song,ZHU Xian-li,et al.Microsurgery for craniopharyngiomas (report of 216 cases)[J].,2015,(06):205.[doi:10.13798/j.issn.1009-153X.2015.04.004]
[5]顾向进　王　东　张党林　张　亮.第三脑室与基底池CT形态改变在额叶挫裂伤救治中的应用[J].中国临床神经外科杂志,2017,(03):174.[doi:10.13798/j.issn.1009-153X.2017.03.016]
[6]李　伟　王增武　秦时强? ?宋仁兴 郭临平.经额底纵裂终板入路手术切除侵犯第三脑室肿瘤[J].中国临床神经外科杂志,2017,(09):646.[doi:10.13792017.09/j.issn.1009-153X.2017.09.012]
[7]晁迎九、陈　昱、高　歌、张　扬、牛朝诗、魏祥品.颅咽管瘤伴前交通动脉动脉瘤1例[J].中国临床神经外科杂志,2017,(09):672.[doi:10.13792017.09/j.issn.1009-153X.2017.09.023]
[8]吕　鹏　张方成.第三脑室内混合性生殖细胞瘤1例[J].中国临床神经外科杂志,2019,(03):192.[doi:10.13798/j.issn.1009-153X.2019.03.024]
[9]孟肖利　万经海.神经内镜下经扩大鼻蝶入路手术切除颅咽管瘤[J].中国临床神经外科杂志,2019,(05):262.[doi:10.13798/j.issn.1009-153X.2019.05.002]
　MENG Xiao-li,WAN Jing-hai.Endosope-assisted neurosurgery through extended endonasal transsphenoidal approach for craniopharyngiomas[J].,2019,(06):262.[doi:10.13798/j.issn.1009-153X.2019.05.002]
[10]李　傲　高　阳　许世辉　张吉云　杜安东　李　敏　李永财.颅脑枪弹伤致第三脑室金属异物1例[J].中国临床神经外科杂志,2020,(05):334.[doi:10.13798/j.issn.1009-153X.2020.05.027]

备注/Memo

备注/Memo:
基金项目：国家自然科学基金（81571242） 通讯作者：王　煜，E-mail：330722474@qq.com
更新日期/Last Update: 2018-06-25