Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China; Department of Neurosurgery, National Clinical Research Center for Geriatric Diseases, Beijing, China.
Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
World Neurosurg. 2024 Jan;181:e35-e44. doi: 10.1016/j.wneu.2023.04.074. Epub 2023 Apr 22.
The profound understanding of anterior transpetrosal approach (ATPA) is increasingly used to treat petroclival meningiomas (PCMs). We introduce the evolution of ATPA and the outcomes of PCMs treatment.
Between January 2013 and December 2019, 128 patients with PCMs underwent surgery. According to tumor extension, we classified the 128 patients into 5 types (I-V), introduced key technologies of ATPA into different types for the first time, and achieved a supreme surgical technology. Clinical data, radiological findings, surgical treatments, complications, and patient outcomes were retrospectively analyzed.
A total of 22 (17.2%), 44 (34.4%), 25 (19.5%), 29 (22.7%), and 8 (6.3%) patients had type I, II, III, IV, and V disease, respectively. Tumors were gross totally removed (Simpson I and II) in 100 patients (78.1%), subtotally removed (Simpson III) in 20 patients (15.6%), and partially removed (Simpson IV) in 8 patients (6.3%). The progression or recurrence rates were 5% (5/100) for gross totally removed, 22.3% (6/20) for subtotally removed, and 62.5% (5/8; 1 died) for partially removed. According to the Karnofsky Performance Scale and Glasgow Outcome Scale, 108 patients had good recovery (84.4%, 108/128) and 115 were independent (89.8%, 115/128) at the end of follow-up.
Because some key technologies were used in ATPA, the application of ATPA was extended, and greater tumor resection and nerve function protection could be achieved in the treatment of PCMs.
对经岩骨前入路（ATPA）的深刻理解越来越多地用于治疗岩斜区脑膜瘤（PCMs）。我们介绍了 ATPA 的演变以及 PCMs 治疗的结果。
2013 年 1 月至 2019 年 12 月，128 例 PCMs 患者接受了手术治疗。根据肿瘤的延伸，我们将 128 例患者分为 5 型（I-V 型），首次将 ATPA 的关键技术引入不同类型，并达到了卓越的手术技术。回顾性分析了临床资料、影像学表现、手术治疗、并发症和患者预后。
共有 22 例（17.2%）、44 例（34.4%）、25 例（19.5%）、29 例（22.7%）和 8 例（6.3%）患者分别患有 I、II、III、IV 和 V 型疾病。100 例患者（78.1%）肿瘤全切（Simpson I 和 II 级），20 例患者（15.6%）次全切（Simpson III 级），8 例患者（6.3%）部分切除（Simpson IV 级）。全切组肿瘤进展或复发率为 5%（5/100），次全切组为 22.3%（6/20），部分切除组为 62.5%（5/8；1 例死亡）。根据 Karnofsky 表现量表和 Glasgow 结果量表，108 例患者在随访结束时恢复良好（84.4%，108/128），115 例患者独立生活（89.8%，115/128）。
由于在 ATPA 中应用了一些关键技术，因此扩展了 ATPA 的应用范围，在治疗 PCMs 时可以实现更大的肿瘤切除和神经功能保护。
