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第三脑室胶样囊肿的显微外科治疗

Microsurgical Treatment of Colloid Cysts of the Third Ventricle.

作者信息

Konovalov Alexander N, Pitskhelauri David I, Shkarubo Michael, Buklina Svetlana B, Poddubskaya Anna A, Kolycheva Mariya

机构信息

Burdenko Neurosurgery Institute, Moscow, Russia.

Burdenko Neurosurgery Institute, Moscow, Russia.

出版信息

World Neurosurg. 2017 Sep;105:678-688. doi: 10.1016/j.wneu.2017.06.012. Epub 2017 Jun 13.

Abstract

BACKGROUND

This study analyzes the results of surgical treatment in 377 patients with colloid cysts (CCs) of the third ventricle who were treated at the Burdenko Neurosurgery Institute from 1981 to 2015. Operations were performed by a single surgeon (the first author of the article).

METHODS

The transcallosal approach was used to remove CCs in 97% of cases. Total cyst removal was performed in 96% of cases (in 4% of cases, a small cyst capsule fragment was left on the veins and fornix); in 3 cases, the cyst recurred, which required its repeated removal.

RESULTS

Hydrocephalus symptoms regressed in 98% of patients. The most frequent complications in the early postoperative period were memory impairments of varying severity, with a tendency to regress by the time of discharge. Two patients had an intraventricular hematoma, which required operative exploration in 1 patient. There were 4 cases of meningitis (including 1 shunt-associated meningitis) and 5 cases of transient pyramidal insufficiency.

CONCLUSIONS

We made a preliminary assessment of the reasonability of the infratentorial supracerebellar approach for removal of CCs in 10 cases.

摘要

背景

本研究分析了1981年至2015年在布尔坚科神经外科研究所接受治疗的377例第三脑室胶样囊肿(CCs)患者的手术治疗结果。手术由一名外科医生(本文第一作者)进行。

方法

97%的病例采用经胼胝体入路切除CCs。96%的病例实现了囊肿全切(4%的病例中,在静脉和穹窿上残留了一小片囊肿包膜);3例囊肿复发,需要再次切除。

结果

98%的患者脑积水症状消退。术后早期最常见的并发症是不同程度的记忆障碍,出院时往往有好转趋势。2例患者发生脑室内血肿,其中1例需要手术探查。有4例脑膜炎(包括1例与分流相关的脑膜炎)和5例短暂性锥体功能不全。

结论

我们对10例采用幕下小脑上入路切除CCs的合理性进行了初步评估。

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