Zhongnan Hospital of Wuhan University, Department of Neurosurgery, Wuhan, Hubei Province, China.
The Affiliated Hospital of Hubei University of Arts and Sciences Xiangyang Central Hospital, Department of Neurosurgery, Xiangyang, Hubei Province, China.
Contrast Media Mol Imaging. 2022 Aug 10;2022:5702309. doi: 10.1155/2022/5702309. eCollection 2022.
Tumors in the pineal region are deep, with complex surrounding anatomy, adjacent to important blood vessels and nerve structures, and surgical resection is difficult and risky. In this paper, we reviewed the literature to understand the epidemiology and clinical manifestations of pineal region tumors in the country and study the clinical indications, related problems, and successful experiences of patients with pineal region tumors treated by the transtentorial-superior approach. The clinical data of 80 patients with pineal region tumors were selected as the retrospective research objects and divided into the control group and the treatment group, with 40 cases in each group, according to the random number table method. The control group was treated using the endoscopic transtentorial approach (Poppen approach), while the treatment group was treated with the endoscopic supratentorial approach (Krause approach). The inflammatory factors, inflammatory stress response, postoperative neurological dysfunction, clinical efficacy, and poor prognosis were observed and compared between the two groups. Tumor resection and recurrence were used to compare the clinical outcomes of tumors in the pineal region. The extent of surgical resection was 100% higher in both groups, and the treatment group was comparable to the control group. The prognosis of patients after the operation was poor. Nausea and vomiting, visual disturbance, upper vision paralysis, and ataxia in the treatment group were significantly lower than those in the control group, with no statistical significance ( > 0.05). At the same time, the bone window can be reduced to reduce trauma and provide a certain reference for patients to choose a safe and complete resection method.
松果体区域的肿瘤较深，周围解剖结构复杂，毗邻重要的血管和神经结构，手术切除困难且风险大。本文通过复习文献，了解松果体区域肿瘤在我国的流行病学及临床表现，并研究经颅-幕上入路治疗松果体区域肿瘤的临床适应证、相关问题及成功经验。选取 80 例松果体区域肿瘤患者的临床资料作为回顾性研究对象，按照随机数字表法分为对照组和治疗组，每组 40 例。对照组采用内镜经颅入路（Poppen 入路）治疗，治疗组采用内镜幕上入路（Krause 入路）治疗。观察并比较两组患者的炎性因子、炎性应激反应、术后神经功能障碍、临床疗效及预后不良情况。观察两组患者的肿瘤切除程度和复发情况，评估肿瘤治疗效果。两组肿瘤切除程度均为 100%，两组间差异无统计学意义（ > 0.05）。术后患者预后较差。治疗组患者的恶心呕吐、视功能障碍、视力上偏麻痹和共济失调发生率明显低于对照组，但差异无统计学意义（ > 0.05）。同时可减少骨窗，减轻创伤，为患者选择安全、完整的切除方法提供一定参考。
