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使用透明管状牵开器对深部病变进行显微手术切除:儿科病例系列

Microsurgical resection of deep-seated lesions using transparent tubular retractor: pediatric case series.

作者信息

Jo Kyung-Il, Chung Sang Bong, Jo Kwang-Wook, Kong Doo-Sik, Seol Ho-Jun, Shin Hyung-Jin

机构信息

Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-gu, 135-710, Seoul, South Korea.

出版信息

Childs Nerv Syst. 2011 Nov;27(11):1989-94. doi: 10.1007/s00381-011-1529-3. Epub 2011 Jul 22.

Abstract

BACKGROUND

To facilitate effective resection of deep-seated brain lesions without causing significant trauma to the overlying cortex, the authors used a transparent plastic tubular retractor to approach these lesions.

METHODS

Between July 2009 and January 2011, we used an 11-mm diameter transparent plastic tubular retractor in combination with a frameless stereotactic navigation system to remove 18 deep lesions.

RESULTS

Gross total resection of the lesions was achieved in 14 of 18 patients, and subtotal removal occurred in four patients. Effective resection of lesions was achieved in all patients through small size craniotomy window and small cortical incision. The histopathologic diagnosis was established in all 18 patients: 3 hematomas, 3 cavernous angioma, 7 low-grade glioma, 2 dysembryoplastic neuroepithelial tumor, 1 choroid plexus papilloma, 1 abscess, and 1 meningioma.

CONCLUSION

Microsurgery using a transparent tubular retractor guided by a neuronavigation system facilitated accurate and effective removal of these deep-seated brain lesions.

摘要

背景

为了在不对上覆皮质造成重大创伤的情况下促进深部脑病变的有效切除,作者使用了一种透明塑料管状牵开器来处理这些病变。

方法

在2009年7月至2011年1月期间,我们使用直径11毫米的透明塑料管状牵开器结合无框架立体定向导航系统切除了18个深部病变。

结果

18例患者中有14例实现了病变的全切除,4例为次全切除。所有患者均通过小骨窗开颅和小皮质切口实现了病变的有效切除。18例患者均确立了组织病理学诊断:3例血肿、3例海绵状血管瘤、7例低级别胶质瘤、2例胚胎发育不良性神经上皮肿瘤、1例脉络丛乳头状瘤、1例脓肿和1例脑膜瘤。

结论

在神经导航系统引导下使用透明管状牵开器进行显微手术有助于准确、有效地切除这些深部脑病变。

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