Nguyen Phuong Xuan, Nguyen Nhan Pham-Sy, Doan Ha Thi-Ngoc, Nguyen Bac Thanh
Department of Neurosurgery, Military Hospital 103.
Neurological Intensive Care Unit, Institute of Neurology, 108 Military Central Hospital.
Ann Med Surg (Lond). 2023 Apr 13;85(5):1737-1742. doi: 10.1097/MS9.0000000000000624. eCollection 2023 May.
Performing microsurgery with the support of navigation in falcine meningioma management shows significant impacts in short and middle-time follow-up, including unilaterally skull opening with smallest and nearest skin incision, lessen the surgical duration, limit blood transfusion and prevent tumours from recurrence.
Sixty-two falcine meningioma patients treated by microoperation applying neuronavigation were enroled from July 2015 to March 2017. Patients are evaluated before and 1 year after surgery according to The Karnofsky Performance Scale (KPS) for comparison.
Histopathology: the most common was fibrous meningioma with 32.26%; meningothelial meningioma was 19.35% and transitional meningioma was 16.13%. KPS I before surgery was 6.45% and after was 83.87%. KPS III who needed assistance in activities preoperation was 64.52% and postoperation was 1.61%. After surgery, there was no disabled patient. All patients were followed up a year after surgery and received MRI to evaluate the recurrence. After 12 months, there were three recurrent cases, accounted for 4.84%.
Microsurgery under neuronavigation help brings significant improvement in patient's functional abilities and low recurrence of falcine meningiomas within 1-year post-surgery. Further studies with large sample size and longer follow-up duration should be performed to reliably evaluate safety and effectiveness of microsurgical neuronavigation in the management of the disease.
在大脑镰旁脑膜瘤治疗中，借助导航技术进行显微手术在短期和中期随访中显示出显著效果，包括采用最小且最接近肿瘤的单侧颅骨切开术、缩短手术时间、减少输血以及预防肿瘤复发。
选取2015年7月至2017年3月间采用神经导航显微手术治疗的62例大脑镰旁脑膜瘤患者。根据卡氏功能状态评分量表（KPS）在手术前和术后1年对患者进行评估以作比较。
组织病理学检查：最常见的是纤维型脑膜瘤，占32.26%；内皮型脑膜瘤占19.35%，过渡型脑膜瘤占16.13%。术前KPS I级为6.45%，术后为83.87%。术前需要协助进行活动的KPS III级患者占64.52%，术后为1.61%。术后无患者致残。所有患者术后随访1年并接受MRI检查以评估复发情况。12个月后，有3例复发，占4.84%。
神经导航下的显微手术有助于显著改善患者的功能状态，且大脑镰旁脑膜瘤术后1年内复发率较低。应开展更大样本量、更长随访时间的进一步研究，以可靠评估显微手术神经导航在该疾病治疗中的安全性和有效性。
