Sun Chongjing, Chen Pin, Zhang Xiaobiao, Huang Jinlong, Liu Shuang, Xie Tao, Liu Tengfei, Li Chen, Xie Qiang, Yang LiangLiang
Department of Neurosurgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.
Neurosurg Rev. 2025 May 23;48(1):436. doi: 10.1007/s10143-025-03606-x.
The lateral ventricle, located deep within the intracranial space, poses significant surgical challenges due to its complex anatomy and proximity to critical neural structures. The purely endoscopic posterior interhemispheric approach, leveraging the natural corridor of the interhemispheric fissure, offers a promising alternative. A retrospective review was conducted on 23 cases of lateral ventricle lesions treated with the purely endoscopic posterior interhemispheric approach between January 2013 and December 2024. Whether an ipsilateral or contralateral approach was chosen was based on lesion characteristics to optimize exposure. Surgical procedures were performed under general anesthesia and utilizing bimanual endoscopic techniques. Total resection was achieved in 21 cases (91.3%), and subtotal resection in 2 cases (8.7%). The endoscopic approach significantly enhanced the operative working range, with ipsilateral access improving anteroposterior exposure and contralateral access expanding lateral exposure. Postoperative complications included intracranial infection (1 case), intraventricular hemorrhage (1 case), and unilateral hydrocephalus (1 case), all of which were managed successfully with no surgery-related mortality. The purely endoscopic posterior interhemispheric approach is a safe and effective minimally invasive treatment for selected lateral ventricular lesions. It significantly expands operative working ranges, offering a valuable addition to neurosurgical practice.
侧脑室位于颅内深部，因其复杂的解剖结构以及与关键神经结构的毗邻关系，给手术带来了重大挑战。单纯内镜下经后纵裂入路利用纵裂的自然通道，提供了一种有前景的替代方法。对2013年1月至2024年12月期间采用单纯内镜下经后纵裂入路治疗的23例侧脑室病变病例进行了回顾性研究。同侧或对侧入路的选择基于病变特征以优化暴露。手术在全身麻醉下进行，并采用双手内镜技术。21例（91.3%）实现了全切，2例（8.7%）为次全切。内镜入路显著扩大了手术操作范围，同侧入路改善了前后方向的暴露，对侧入路扩大了外侧暴露。术后并发症包括颅内感染（1例）、脑室内出血（1例）和单侧脑积水（1例），所有这些均成功处理，无手术相关死亡。单纯内镜下经后纵裂入路是治疗特定侧脑室病变的一种安全有效的微创治疗方法。它显著扩大了手术操作范围，为神经外科实践增添了有价值的内容。
