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微创神经外科手术:钻孔技术在一系列脑病变中的应用

Minimally invasive neurosurgery: application of burr-hole technique across a spectrum of brain lesions.

作者信息

Huo Jun-Feng, Zheng Jia-Jia, Helmy Mohamed, Liu Min-Di, Zhang Xue-Jun, Song Dong-Lei, Sun Wei

机构信息

Department of Neurosurgery, Shanghai Donglei Brain Hospital, No. 988# Road Huaxu, Qingpu Area, 201702, Shanghai, China.

Department of Neurosurgery, China Rehabilitation Research Center Beijing Boai Hospital, No. 10 Jiaomen North Road, Fengtai District, Beijing, China.

出版信息

Neurosurg Rev. 2024 Dec 18;47(1):903. doi: 10.1007/s10143-024-03151-z.

Abstract

OBJECTIVE

The burr-hole technique is a minimally invasive transcranial approach designed to minimize the surgical incision size and reduce disruption to brain tissue. We aimed to share our experience with the burr-hole technique for removing brain lesions and to evaluate its effectiveness in treating appropriately sized intra-axial brain lesions.

METHODS

In this retrospective cohort study, we analyzed the clinical features, radiological characteristics, surgical techniques, and outcomes of patients who underwent burr-hole surgery for intra-axial brain lesions between January 2019 and December 2023.

RESULTS

A total of 81 patients were included in the study. Gross total resection was achieved in 74 patients (91.4%), whereas subtotal resection was performed in 7 patients (8.6%). There were no perioperative deaths, cerebrospinal fluid leaks, or wound infections. The median follow-up duration was 40.5 months (range, 4.1-63.7 months). At the end of the follow-up period, 14 patients (17.3%) experienced recurrence, including 6 with glioma and 8 with primary cerebral lymphoma. Among these patients, 10 died due to lesion recurrence.

CONCLUSIONS

The burr-hole approach using a retractable tubular device is a safe and effective method for the removal of brain lesions. As a novel minimally invasive technique, it significantly facilitates and accelerates the evolution of microsurgical outcomes.

摘要

目的

骨孔技术是一种微创经颅入路,旨在将手术切口尺寸最小化,并减少对脑组织的破坏。我们旨在分享我们使用骨孔技术切除脑病变的经验,并评估其治疗适当大小的脑内病变的有效性。

方法

在这项回顾性队列研究中,我们分析了2019年1月至2023年12月期间接受骨孔手术治疗脑内病变的患者的临床特征、放射学特征、手术技术和结果。

结果

该研究共纳入81例患者。74例患者(91.4%)实现了全切除,7例患者(8.6%)进行了次全切除。没有围手术期死亡、脑脊液漏或伤口感染。中位随访时间为40.5个月(范围4.1 - 63.7个月)。在随访期结束时,14例患者(17.3%)出现复发,其中6例为胶质瘤,8例为原发性脑淋巴瘤。在这些患者中,10例因病变复发死亡。

结论

使用可伸缩管状装置的骨孔入路是一种安全有效的脑病变切除方法。作为一种新型微创技术,它显著促进并加速了显微手术结果的发展。

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