Karki Mohan, Vaish Manish, Bundela Yaspal Singh, Chakrabartty Hrishikesh, Roka Yam Bahadur, Narula Dipanshu, Pandey Rakesh
Department of Neurosurgery, Max Super Speciality Hospital, Vaishali, Ghaziabad, Uttar Pradesh, India.
Department of Neurosurgery, Gandaki Medical College, Pokhara, Nepal.
Asian J Neurosurg. 2025 May 16;20(3):572-580. doi: 10.1055/s-0045-1809154. eCollection 2025 Sep.
Deeply located intracranial lesions such as intraparenchymal and intraventricular lesions are surgically challenging and associated with unavoidable complications such as seizure, surgical bed hematoma, and brain contusion caused by traction. The objective of this study is to evaluate the safety and effectiveness of the microscopic tubular retractor of a plastic syringe for the resection of deeply located brain lesions.
We retrospectively studied 157 patients with deep-seated intracranial lesions who underwent microscopic resection with the help of a tubular retractor made of a plastic syringe and Teflon introducer between January 2018 and January 2024 in a tertiary hospital. All deep-seated lesions were such as neurocytoma, lymphoma, ependymoma, colloid cysts, metastatic brain tumors, astrocytoma, and meningiomas. We evaluated all patients postoperatively with computed tomography (CT) scan on the first/second day of surgery. The amount of blood loss, the complications, and the mortality rate were recorded.
There were 104 males and 53 females with a mean age of 54.13 (range: 15-80) years. Gross total resection was obtained in 85.35% and subtotal in 14.65% of patients. Complications such as surgical bed hematoma in 5.73%, seizure in 3.18%, weakness in 2.54%, and contusion in 3.82% of patients were noted. The blood loss varied from 30 to 500 mL (average, 100 mL). The mortality rate was observed in 2.54% of all patients. Follow-up ranged from 1 to 25 months (average, 10 months).
Plastic syringe tubular retractor with Teflon introducer system is safe and effective for the treatment of deeply located intracranial lesions in terms of low morbidity and excellent rate of resection.
脑实质内和脑室内等深部颅内病变的手术具有挑战性，且伴有不可避免的并发症，如癫痫发作、手术床血肿以及牵引导致的脑挫伤。本研究的目的是评估塑料注射器微型管状牵开器在深部脑病变切除术中的安全性和有效性。
我们回顾性研究了2018年1月至2024年1月在一家三级医院借助由塑料注射器和聚四氟乙烯导入器制成的管状牵开器接受显微切除术的157例深部颅内病变患者。所有深部病变包括神经细胞瘤、淋巴瘤、室管膜瘤、胶样囊肿、脑转移瘤、星形细胞瘤和脑膜瘤。我们在术后第一天/第二天对所有患者进行计算机断层扫描（CT）评估。记录失血量、并发症和死亡率。
男性104例，女性53例，平均年龄54.13岁（范围：15 - 80岁）。85.35%的患者实现了全切，14.65%的患者为次全切。注意到5.73%的患者出现手术床血肿、3.18%的患者出现癫痫发作、2.54%的患者出现无力、3.82%的患者出现挫伤等并发症。失血量在30至500毫升之间（平均100毫升）。所有患者的死亡率为2.54%。随访时间为1至25个月（平均10个月）。
带聚四氟乙烯导入器系统的塑料注射器管状牵开器在治疗深部颅内病变方面具有低发病率和高切除率，是安全有效的。
