Lepsveridze Levan Teymurazovich, Semenov Maksim Sergeevich, Simonyan Armen Samvelovich, Pirtskhelava Salome Zurabovna, Stepanyan Georgy Garikovich, Imerlishvili Lado Kobaevich
Department of Neurosurgery, Burnazian FMBC Research Center of FMBA of Russia, Moscow.
Department of Neurology, Medical Center of Radiology, Krasnodar, Russian Federation.
Surg Neurol Int. 2020 Aug 21;11:255. doi: 10.25259/SNI_273_2020. eCollection 2020.
Modern technical capabilities have made minimally invasive surgery increasingly popular. Small incisions can reduce surgical duration and the degree of tissue trauma, which reduces the risk of complications. Burr hole microsurgery is a relatively new minimally invasive technique used in neurosurgery. The objective of this study was to assess the feasibility and outcomes of using burr hole microsurgery for the management of intracranial lesions.
Forty-four adults were treated with burr hole microsurgery. Patients were divided into groups according to the presence of (1) brain tumors ( = 20); (2) congenital brain cysts ( = 16); (3) cavernous angiomas ( = 3); and (4) neurovascular conflicts of the 5 cranial nerve ( = 5). All surgical interventions were performed using the "MARI" device.
The transcortical approach was used to remove 16 brain tumors, and 2 brain tumors were biopsied. In the two tumor biopsy cases, the parasagittal interhemispheric route was used. Gross total resection was achieved in 10 cases (62.5%) when tumor size reached up to 4 cm, subtotal resection was achieved in four cases (25%) in large tumors, and partial resection in two cases (12.5%). In patients with congenital cysts, cavernous angiomas, trigeminal neuralgia, and symptomatic regression were noted the postoperative period. The surgical duration was 30-180 min (median, 75 min). A hemorrhagic complication was observed in one case. Significant postoperative complications and mortality were not observed.
Burr hole microsurgery can treat different intracranial lesions effectively. Despite a smaller craniotomy diameter of 11-14 mm compared with keyhole approaches, surgery was successful.
现代技术能力使微创手术越来越受欢迎。小切口可缩短手术时间并降低组织创伤程度，从而降低并发症风险。骨孔显微手术是神经外科中一种相对较新的微创手术技术。本研究的目的是评估使用骨孔显微手术治疗颅内病变的可行性和效果。
44名成年人接受了骨孔显微手术治疗。患者根据病变情况分为以下几组：（1）脑肿瘤（n = 20）；（2）先天性脑囊肿（n = 16）；（3）海绵状血管瘤（n = 3）；（4）第5对脑神经的神经血管冲突（n = 5）。所有手术干预均使用“MARI”设备进行。
采用经皮质入路切除16例脑肿瘤，2例脑肿瘤进行了活检。在这两例肿瘤活检病例中，采用了矢状窦旁半球间入路。肿瘤大小达4 cm时，10例（62.5%）实现了全切，大肿瘤4例（25%）实现了次全切，2例（12.5%）实现了部分切除。对于先天性囊肿、海绵状血管瘤、三叉神经痛患者，术后症状出现缓解。手术时间为30 - 180分钟（中位数，75分钟）。1例观察到出血并发症。未观察到明显的术后并发症和死亡情况。
骨孔显微手术可有效治疗不同的颅内病变。尽管与锁孔入路相比颅骨切开直径较小，为11 - 14 mm，但手术成功。
