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额叶低级别胶质瘤的长期手术和癫痫发作结果。

Long-term surgical and seizure outcomes of frontal low-grade gliomas.

机构信息

Department of Neurosurgery, Cerrahpasa Medical Faculty, Istanbul University, Fatih, 34098 Istanbul, Turkey.

Department of Neurosurgery, Cerrahpasa Medical Faculty, Istanbul University, Fatih, 34098 Istanbul, Turkey.

出版信息

Int J Surg. 2016 Sep;33 Pt A:60-4. doi: 10.1016/j.ijsu.2016.07.065. Epub 2016 Jul 28.

Abstract

INTRODUCTION

Low-grade gliomas are infrequent lesions requiring special emphasis because of their relatively long follow-up time, and therefore the need for patients' well-being. Surgery provides not only increased survival but also improved quality of life for these patients. The purpose of this study was to present surgical series of frontal low-grade gliomas that were operated in our clinic and to discuss their epileptic and functional outcomes.

METHODS

A series of 40 patients with low-grade glioma (WHO Grade II) were retrospectively analysed for patient characteristics, tumour location, epileptic history, surgery type (awake craniotomy, general anaesthesia), extent of resection and complications.

RESULTS

Tumour was localized to primary motor area in most of the cases (35%, n = 14), 25 patients were operated under general anaesthesia and 15 with awake craniotomy. New deficit rate in the early postoperative period was 32.5% (dysarthria in one patient and motor deficits in 12). Karnofsky scores were ≥90 in 92.5% of the patients at the late follow-up. 31 patients were Engel I (77.5%), 5 were Engel II (12.5%) and 4 were Engel IV (10%) postoperatively.

CONCLUSION

Frontal LGGs are eligible to resect vigorously without persistent functional deficits. Patients with immediate postoperative complications benefit from neuro-rehabilitation. However, pre-existing speech dysfunctions are hard to recover with surgery. Surgical resection ends with favourable epileptic outcomes whereas tumour location may influence the results.

摘要

简介

低级别胶质瘤较为罕见,由于其随访时间相对较长,因此需要特别关注患者的整体健康状况。手术不仅可以提高生存率,还可以改善此类患者的生活质量。本研究旨在展示在我院接受手术治疗的额叶低级别胶质瘤患者的手术系列,并讨论其癫痫和功能预后。

方法

回顾性分析了 40 例低级别胶质瘤(WHO 分级 II 级)患者的临床资料,包括患者特征、肿瘤位置、癫痫病史、手术类型(清醒开颅术、全身麻醉)、切除范围和并发症。

结果

肿瘤定位于初级运动区的病例占大多数(35%,n=14),25 例患者在全身麻醉下进行手术,15 例患者在清醒开颅术下进行手术。术后早期新发缺损率为 32.5%(1 例患者出现构音障碍,12 例患者出现运动障碍)。在晚期随访中,92.5%的患者的 Karnofsky 评分≥90。术后 31 例患者为 Engel I 级(77.5%),5 例患者为 Engel II 级(12.5%),4 例患者为 Engel IV 级(10%)。

结论

额叶低级别胶质瘤可进行积极切除,且不会出现持续的功能缺损。有术后即刻并发症的患者受益于神经康复。然而,术前存在的言语障碍术后难以恢复。手术切除可获得良好的癫痫预后,而肿瘤位置可能会影响手术结果。

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