Barnett G H, McKenzie R L, Ramos L, Palmer J
Center for Computer-Assisted Neurosurgery, Cleveland Clinic Foundation, Ohio.
Stereotact Funct Neurosurg. 1993;61(2):80-95. doi: 10.1159/000100625.
Craniotomy using stereotactic techniques has the potential to improve the extent of tumor resection and to reduce wound and neurologic morbidity. Most reports of stereotaxy-assisted craniotomy (SC) for tumor resection have focused on techniques using sophisticated computer hardware and volumetric software. Results of nonvolumetric SC in 50 consecutive cases for tumor using the Brown-Roberts-Wells or Cosman-Roberts-Wells stereotactic systems are presented. Tumor type included malignant glial neoplasms (20 cases), metastases (19), benign glial tumors (5), meningiomas (4), and radiation necrosis (1). Results in the SC group were compared to a concurrent series of 50 conventional craniotomies (CC) for brain tumor by other surgeons. Sustained neurologic deficits were 4% in the SC group while 10% for CC. Wound complications were 4 and 8%, respectively. Median hospital stay was 5 days (mean 5.9, range 2-20) for SC and 7 days (mean 10.4, range 3-75) for CC. Low morbidity resections of many brain lesions can be performed using conventional stereotactic systems, the operating microscope and standard CT software.
采用立体定向技术的开颅手术有提高肿瘤切除范围、降低伤口及神经并发症发生率的潜力。大多数关于立体定向辅助开颅手术（SC）切除肿瘤的报告都集中在使用复杂计算机硬件和容积软件的技术上。本文介绍了连续50例使用Brown-Roberts-Wells或Cosman-Roberts-Wells立体定向系统进行非容积性SC切除肿瘤的结果。肿瘤类型包括恶性神经胶质瘤（20例）、转移瘤（19例）、良性神经胶质瘤（5例）、脑膜瘤（4例）和放射性坏死（1例）。将SC组的结果与其他外科医生同期进行的50例常规开颅手术（CC）切除脑肿瘤的系列结果进行比较。SC组持续性神经功能缺损发生率为4%，而CC组为10%。伤口并发症发生率分别为4%和8%。SC组的中位住院时间为5天（平均5.9天，范围2 - 20天），CC组为7天（平均10.4天，范围3 - 75天）。使用传统立体定向系统、手术显微镜和标准CT软件可对许多脑病变进行低并发症的切除。
