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巨大高血运肿瘤的杂交手术治疗:术中血管内栓塞联合显微手术切除

Hybrid Surgery Management of Giant Hypervascular Tumors: Intraoperative Endovascular Embolization with Microsurgical Resection.

作者信息

Almefty Rami O, Patel Nirav J, See Alfred P, Dunn Ian F, Al-Mefty Ossama, Aziz-Sultan Mohammed Ali

机构信息

Department of Neurosurgery, Brigham and Women Hospital, Harvard School of Medicine, Boston, Massachusetts, USA; Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA.

Department of Neurosurgery, Brigham and Women Hospital, Harvard School of Medicine, Boston, Massachusetts, USA.

出版信息

World Neurosurg. 2017 Jun;102:157-166. doi: 10.1016/j.wneu.2017.02.092. Epub 2017 Mar 1.

Abstract

BACKGROUND

Giant hypervascular intracranial tumors represent a formidable challenge because their size limits surgical control of the blood supply and debulking poses the risk of critical blood loss. Embolization facilitates resection but carries the risk of life-threatening tumor infarction, hemorrhage, or swelling if performed preoperatively. Endovascular intraoperative embolization avoids the fatal risk and allows the surgeon to attend instantly if any complication occurs.

METHODS AND RESULTS

We report 2 cases in which combining intraoperative embolization with microsurgical resection in the hybrid operating room was used to safely and successfully remove giant hypervascular tumors.

CONCLUSIONS

Intraoperative embolization facilitates the safe resection of giant hypervascular tumors and mitigates the consequences of potential tumor infarction, hemorrhage, or swelling from embolization. These cases exemplify the benefits of combining expertise in endovascular and microsurgical techniques with the capabilities of modern hybrid operating rooms allowing for their simultaneous application.

摘要

背景

巨大的颅内富血管肿瘤是一项艰巨的挑战,因为其大小限制了对血供的手术控制,而肿瘤减容存在严重失血的风险。栓塞有助于切除,但如果在术前进行,会有危及生命的肿瘤梗死、出血或肿胀的风险。血管内术中栓塞可避免致命风险,并在出现任何并发症时使外科医生能够立即处理。

方法与结果

我们报告了2例在杂交手术室中将术中栓塞与显微手术切除相结合,从而安全、成功地切除巨大富血管肿瘤的病例。

结论

术中栓塞有助于安全切除巨大富血管肿瘤,并减轻栓塞引起的潜在肿瘤梗死、出血或肿胀的后果。这些病例体现了将血管内和显微外科技术专长与现代杂交手术室的功能相结合以实现同时应用的益处。

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