Honegger Jürgen, Tatagiba Marcos
Department of Neurosurgery, University of Tuebingen, Tuebingen, Germany.
Pituitary. 2008;11(4):361-73. doi: 10.1007/s11102-008-0137-z.
Ideal surgical treatment of craniopharyngiomas remains a major challenge for neurosurgeons. Craniopharyngiomas grow in the deep-seated hypothalamic area that is paramount for vegetative, emotional and endocrine function, and for maintaining worthwhile life. The benign histological nature of craniopharyngiomas belies their biological behavior and the propensity to recur is a major threat. Surgical treatment has to weigh the risk of hypothalamic damage against the risk of tumor recurrence or progression. Both aggressive surgery and conservative minor surgery followed by radiotherapy has been proclaimed by the proponents of different schools. During the past decade, the pendulum has swung back to surgery with the attempt at radical removal. Refined neurosurgical techniques and innovative approaches yielded improved surgical results. The contemporary neurosurgical strategy of treating craniopharyngiomas with early and late outcome data is presented. Neurosurgical therapy is only beneficial in the context of an interdisciplinary treatment concept as discussed here.
颅咽管瘤的理想手术治疗仍然是神经外科医生面临的一项重大挑战。颅咽管瘤生长于下丘脑深部区域，该区域对营养、情绪和内分泌功能以及维持有价值的生活至关重要。颅咽管瘤组织学上的良性本质掩盖了其生物学行为，而复发倾向是一个主要威胁。手术治疗必须权衡下丘脑损伤风险与肿瘤复发或进展风险。激进手术和保守的小手术联合放疗都得到了不同学派支持者的宣扬。在过去十年中，随着试图根治性切除，天平又摆回了手术治疗。精细的神经外科技术和创新方法带来了更好的手术效果。本文介绍了用早期和晚期结果数据治疗颅咽管瘤的当代神经外科策略。如本文所讨论的，神经外科治疗只有在跨学科治疗理念的背景下才有益处。
