Xu Jian-guo, You Chao, Cai Bo-wen, Jiang Shu, Sun Hong, Guo Fu-you, Yang Yong-bo, Wu Bo
Department of Neurosurgery, Huaxi Hospital, Sichuan University, Chengdu 610044, China.
Chin Med J (Engl). 2005 May 20;118(10):806-11.
Craniopharyngioma of the third ventricle is difficult to treat and its therapeutic regimens and operative approaches have been controversial. This study was undertaken to probe indications for microsurgical resection of craniopharyngioma of the third ventricle via an improved transventricular approach, its surgical procedures and therapeutic effects, and prevention of postoperative complications.
Fifty-one patients with craniopharyngioma of the third ventricle were treated from January 2000 to October 2004 by an improved transventricular approach for removing the tumor via the interventricular foramen, the intermedius of the septum pellucidum or choroid fissure. Symptoms and signs of the patients, and results of imaging, operation, and follow-up were analyzed.
Of the 51 patients who had received the improved transventricular resection, 4 underwent a combined approach with an entrance of the pterion. Forty patients (78.43%) underwent total resection and others subtotal resection, without an operative death. Epileptic seizures were found in 3 patients (5.88%) and subdural effusion in the operative field in 4 (7.84%). All patients showed good general conditions after operation, and follow-up for an average of 27.52 months showed relapse of the tumour in 8 patients (15.69%).
Microsurgical resection of craniopharyngioma of the third ventricle by an improved transventricular approach has advantages of operative safety and efficacy, lower mortality and disability, and less complications.
第三脑室颅咽管瘤治疗困难，其治疗方案及手术入路一直存在争议。本研究旨在探讨经改良经脑室入路显微手术切除第三脑室颅咽管瘤的适应证、手术方法、治疗效果及术后并发症的预防。
2000年1月至2004年10月，采用改良经脑室入路，经室间孔、透明隔中间部或脉络膜裂切除肿瘤，治疗51例第三脑室颅咽管瘤患者。分析患者的症状、体征及影像学、手术和随访结果。
51例行改良经脑室切除术的患者中，4例采用翼点入路联合手术。40例（78.43%）全切除，其余次全切除，无手术死亡。3例（5.88%）出现癫痫发作，4例（7.84%）术野出现硬膜下积液。所有患者术后一般情况良好，平均随访27.52个月，8例（15.69%）肿瘤复发。
经改良经脑室入路显微手术切除第三脑室颅咽管瘤具有手术安全有效、死亡率和致残率低、并发症少等优点。
