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采用微创端口技术治疗大型脑室内脑膜瘤:三例系列报道

Management of large intraventricular meningiomas with minimally invasive port technique: a three-case series.

作者信息

Jamshidi Ali O, Beer-Furlan Andre, Hardesty Douglas A, Ditzel Filho Leo F S, Prevedello Luciano M, Prevedello Daniel M

机构信息

Department of Neurological Surgery, Wexner Medical Center, The Ohio State University College of Medicine, 410 W 10th Ave, N-1011 Doan Hall, Columbus, OH, 43210, USA.

Department of Neurological Surgery, Rush University Medical Center, Chicago, IL, USA.

出版信息

Neurosurg Rev. 2021 Aug;44(4):2369-2377. doi: 10.1007/s10143-020-01409-w. Epub 2020 Oct 12.

Abstract

The use of minimally invasive transcranial ports for the resection of deep-seated lesions has been shown to be safe and effective. To date, most of the literature regarding the tubular retractors used in brain surgery is comprised of individual case reports that describe the successful resection of deep-seated lesions such as thalamic pilocytic astrocytomas, colloid cysts in the third ventricle, hematomas, and cavernous angiomas. The authors describe their experience using a tubular retractor system with three different cases involving large intraventricular meningiomas and examine radiographic and patient outcomes. A single-institution, retrospective case series was performed from a skull base database. Patients who underwent resection of intraventricular > 4-cm meningiomas with port technology were identified. The authors reviewed three cases to illustrate the feasibility of minimal access port surgery for the resection of these lesions. Complete resection was achieved in all cases. None of the patients developed permanent neurological deficits. There were no major complications related to surgery and no mortalities. Good clinical and surgical outcomes for atrium meningiomas can be achieved through the minimally invasive port technique and tumor size does not appear to be a limitation.

摘要

使用微创经颅端口切除深部病变已被证明是安全有效的。迄今为止,关于脑外科手术中使用的管状牵开器的大多数文献都是由个别病例报告组成,这些报告描述了深部病变的成功切除,如丘脑毛细胞型星形细胞瘤、第三脑室的胶样囊肿、血肿和海绵状血管瘤。作者描述了他们使用管状牵开器系统治疗三例大型脑室内脑膜瘤的经验,并检查影像学和患者预后。从颅底数据库进行了一项单机构回顾性病例系列研究。确定了使用端口技术切除脑室内大于4厘米脑膜瘤的患者。作者回顾了三例病例,以说明微创端口手术切除这些病变的可行性。所有病例均实现了完全切除。没有患者出现永久性神经功能缺损。没有与手术相关的重大并发症,也没有死亡病例。通过微创端口技术可以实现心房脑膜瘤良好的临床和手术效果,肿瘤大小似乎不是一个限制因素。

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