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影响前床突脑膜瘤治疗术后疗效的因素及最佳手术策略分析。

The factors influencing postoperative efficacy of anterior clinoidal meningioma treatment and an analysis of best-suited surgical strategies.

作者信息

Chen Li-Hua, Xia Yong, Wei Fan, Sun Kai, Huang Hong-Zhi, Xu Ru-Xiang

机构信息

Department of Neurosurgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.

Department of Neurosurgery, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China.

出版信息

Front Neurol. 2023 Mar 16;14:1097686. doi: 10.3389/fneur.2023.1097686. eCollection 2023.

Abstract

OBJECTIVE

To explore the influence of the type of anterior clinoidal meningioma on surgical strategy planning, surgical approach selection, and postoperative efficacy.

PATIENTS AND METHODS

We conducted a retrospective analysis of the clinical data of 63 cases, including data on visual function, extent of tumor resection, and postoperative follow-up. Grade I and II approaches were selected according to the type of tumor. A univariate analysis of the factors influencing the extent of tumor resection, postoperative visual function, and postoperative relapse and complications was conducted.

RESULTS

Simpson Grade I-II total resection was seen in 48 cases (76.2%), with an overall relapse/progression rate of 12.7%. The tumor type and texture and the relationship between the tumors and adjacent structures were the main factors influencing total tumor resection ( < 0.01). The overall postoperative visual acuity improvement, stabilization rate, and deterioration rate were 76.2, 15.9, and 7.9%, respectively. Postoperative visual acuity level was significantly correlated with preoperative visual acuity level and tumor type ( < 0.01).

CONCLUSIONS

Determining the type of tumor at a preoperative level and whether the optic canal and cavernous sinus are invaded can aid in the planning of detailed individualized surgical strategies.

摘要

目的

探讨前床突脑膜瘤的类型对手术策略规划、手术入路选择及术后疗效的影响。

患者与方法

我们对63例患者的临床资料进行了回顾性分析,包括视觉功能、肿瘤切除范围及术后随访数据。根据肿瘤类型选择Ⅰ级和Ⅱ级入路。对影响肿瘤切除范围、术后视觉功能、术后复发及并发症的因素进行单因素分析。

结果

48例(76.2%)实现辛普森Ⅰ - Ⅱ级全切,总体复发/进展率为12.7%。肿瘤类型和质地以及肿瘤与相邻结构的关系是影响肿瘤全切的主要因素(<0.01)。术后视力总体改善、稳定和恶化率分别为76.2%、15.9%和7.9%。术后视力水平与术前视力水平及肿瘤类型显著相关(<0.01)。

结论

术前确定肿瘤类型以及视神经管和海绵窦是否受侵有助于制定详细的个体化手术策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3c3/10060889/b5d4f7a0e000/fneur-14-1097686-g0001.jpg

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