Wang C, Zhang J, Liu A, Sun B, Zhao Y
Department of Neurosurgery, Beijing Tiantan Hospital, Beijing Neurosurgical Institute, PR China.
Surg Neurol. 2000 Jan;53(1):41-51. doi: 10.1016/s0090-3019(99)00165-2.
The treatment of brainstem gliomas remains controversial. This article focuses on surgical results.
The authors retrospectively analyzed 35 patients with primary midbrain gliomas who were treated at Beijing Neurosurgical Institute from 1986 to 1997. The diagnosis was verified by histological examination.
The incidence of midbrain glioma was 10.3% (35/340) in our patients with brain stem tumors. The 35 gliomas were classified into three therapeutic groups by their locations: 7 were located in the tectal region, 8 in the aqueductal region, and 20 in the tegmental region. All of the patients underwent microsurgical treatment based on a minimally invasive approach. The operation took the form of total resection in 19 cases, subtotal resection in 12, and partial resection in 4. The operative mortality was 0. With a mean follow-up of 28 months (range, 6-48 months), 65.7% (23/35) of patients could live independently.
The volume and location of midbrain tumors were highly correlated with outcome. The resection of as much tumor as possible was optimal for the treatment of midbrain gliomas and radiotherapy after operation was beneficial to patients.
脑干胶质瘤的治疗仍存在争议。本文重点关注手术结果。
作者回顾性分析了1986年至1997年在北京神经外科研究所接受治疗的35例原发性中脑胶质瘤患者。诊断经组织学检查证实。
在我们的脑干肿瘤患者中，中脑胶质瘤的发病率为10.3%（35/340）。35例胶质瘤根据其位置分为三个治疗组：7例位于顶盖区，8例位于导水管区，20例位于被盖区。所有患者均采用微创入路进行显微手术治疗。手术方式为全切除19例，次全切除12例，部分切除4例。手术死亡率为0。平均随访28个月（范围6 - 48个月），65.7%（23/35）的患者能够独立生活。
中脑肿瘤的体积和位置与预后高度相关。尽可能多地切除肿瘤对中脑胶质瘤的治疗最为理想，术后放疗对患者有益。
