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松果体区肿瘤的显微外科治疗。

Microsurgical Management of Pineal Region Tumors.

机构信息

Department of Neurosurgery, The First Affiliated Hospital of Soochow University, Suzhou, China.

Department of Neurosurgery, Shaanxi Provincial People's Hospital, Xi'an, China.

出版信息

World Neurosurg. 2024 Oct;190:e165-e174. doi: 10.1016/j.wneu.2024.07.082. Epub 2024 Jul 19.

DOI:10.1016/j.wneu.2024.07.082
PMID:39032641
Abstract

BACKGROUND

Pineal tumors are rare, and the pineal region is a challenging surgical location for neurosurgeons. The present study aimed to investigate the effects of microsurgical management in patients with pineal region tumors and explore probable factors associated with preoperative hydrocephalus, postoperative hydrocephalus remission, and prolonged hospital length of stay (LoS).

METHODS

A retrospective study of patients with pineal region tumors who underwent microsurgical management at the First Affiliated Hospital of Soochow University (Jiangsu, China) between 1 January 2010 and 31 October 2022 was conducted.

RESULTS

Data from 36 patients were included in this study. The top 5 common symptoms included headache (58%), dizziness (44%), double vision (22%), vomiting (19%), and nausea (14%). Patients with a lower Karnofsky Performance Score (KPS), younger age, and larger maximum tumor diameters were more vulnerable to preoperative hydrocephalus. Preoperative hydrocephalus also led to a prolonged postoperative LoS (P = 0.021). Patients with a lower KPS score (P = 0.020) or larger maximum tumor diameters (P = 0.045) were more likely to achieve postoperative remission of hydrocephalus. Most postoperative complications led to increased hospital LoS.

CONCLUSIONS

Microsurgical resection of pineal tumors yielded favorable long-term outcomes. Patients with a lower KPS score, younger age, and larger maximum tumor diameters were more vulnerable to preoperative hydrocephalus and prolonged LoS. Patients with a lower KPS score or larger tumor diameter were likely to achieve significant remission of hydrocephalus after tumor resection.

摘要

背景

松果体肿瘤较为罕见,且松果体区域对神经外科医生来说是一个极具挑战性的手术部位。本研究旨在探讨松果体区域肿瘤患者采用显微镜手术治疗的效果,并探讨与术前脑积水、术后脑积水缓解以及住院时间延长相关的可能因素。

方法

对 2010 年 1 月 1 日至 2022 年 10 月 31 日在苏州大学附属第一医院接受显微镜手术治疗的松果体区域肿瘤患者进行回顾性研究。

结果

本研究共纳入 36 例患者。最常见的 5 种症状包括头痛(58%)、头晕(44%)、复视(22%)、呕吐(19%)和恶心(14%)。Karnofsky 表现状态评分(KPS)较低、年龄较小和最大肿瘤直径较大的患者更容易发生术前脑积水。术前脑积水还导致术后住院时间延长(P=0.021)。KPS 评分较低(P=0.020)或最大肿瘤直径较大(P=0.045)的患者术后脑积水缓解的可能性更大。大多数术后并发症导致住院时间延长。

结论

显微镜下切除松果体肿瘤可获得良好的长期效果。KPS 评分较低、年龄较小和最大肿瘤直径较大的患者更容易发生术前脑积水和住院时间延长。KPS 评分较低或肿瘤直径较大的患者术后肿瘤切除后脑积水可能显著缓解。

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