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手术切除范围对硬脊膜内髓外支气管源性囊肿患者的影响:一项机构回顾性研究及文献综述

Impact of the Extent of Surgical Resection on Patients With Intradural Extramedullary Bronchogenic Cysts: A Retrospective Institutional Experience and Review of the Literature.

作者信息

Liu Jinghui, Wang Yuan, Li Chen, Ji Peigang, Guo Shaochun, Zhai Yulong, Wang Na, Lou Miao, Xu Meng, Chao Min, Feng Fuqiang, Yan Ming, Wang Liang

机构信息

Department of Neurosurgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China.

Department of Neurosurgery, The Second Hospital of Shanxi Medical University, Taiyuan, China.

出版信息

Front Neurol. 2021 Dec 2;12:706742. doi: 10.3389/fneur.2021.706742. eCollection 2021.

Abstract

Intradural extramedullary bronchogenic cysts (IEBC) are rare congenital cystic lesions. The clinical manifestations, radiological characteristics, especially the optimal treatment regimen are not well-understood. We retrospectively analyzed a series of patients with confirmed IEBC in Tangdu hospital and reviewed the published works to gain a comprehensive understanding of IEBC. In our institution, nine consecutive patients had pathologically confirmed IEBC between 2005 and 2018. We also identified 27 patients from previous studies. The most common presentations on magnetic resonance imaging (MRI) were hypointensity on T1-weighted images (T1WI), hyperintensity on T2-weighted images(T2WI), and no improvement on T1WI contrast-enhanced with gadolinium (94.4%). All patients in our center and the patients we reviewed received surgical resection; gross total resection (GTR) and partial resection (PR) were achieved in 20 (55.6%) and 16 (44.4%) patients, respectively. The symptom remission rate of patients who underwent GTR was 100%, which was similar to those who underwent PR (93.8%) ( = 0.457). The recurrence rate was 12.5% in the group who underwent PR and nil after GTR ( = 0.202). According to our current investigation, the surgical resection degree is irrelevant to the symptom remission rate. Therefore, we suggest that total resection should not be recommended for cases with tight adhesion. For patients with PR, longer follow-up will be necessary to determine the long-term outcome.

摘要

硬脊膜内髓外支气管源性囊肿(IEBC)是一种罕见的先天性囊性病变。其临床表现、影像学特征,尤其是最佳治疗方案尚不清楚。我们回顾性分析了唐都医院一系列确诊为IEBC的患者,并查阅了已发表的文献,以全面了解IEBC。在我们机构,2005年至2018年间有9例连续患者经病理证实为IEBC。我们还从先前的研究中确定了27例患者。磁共振成像(MRI)上最常见的表现为T1加权像(T1WI)低信号、T2加权像(T2WI)高信号以及T1WI钆增强后无强化(94.4%)。我们中心的所有患者以及我们查阅的患者均接受了手术切除;分别有20例(55.6%)和16例(44.4%)患者实现了全切除(GTR)和部分切除(PR)。接受GTR的患者症状缓解率为100%,与接受PR的患者(93.8%)相似(P = 0.457)。接受PR的患者组复发率为12.5%,GTR后无复发(P = 0.202)。根据我们目前的研究,手术切除程度与症状缓解率无关。因此,我们建议对于粘连紧密的病例不推荐全切除。对于接受PR的患者,需要更长时间的随访来确定长期预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2fc/8674416/3244ff20dcb6/fneur-12-706742-g0001.jpg

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