经额底纵裂入路切除颅咽管瘤(附83例分析)

Removal of craniopharyngioma via fronto-basal interhemispheric approach:analysis of 83 cases

目的探讨经额底纵裂入路切除颅咽管瘤的手术方法和疗效。方法回顾性分析83例经额底纵裂入路手术的颅咽管瘤病人的临床资料。其中复发性颅咽管瘤33例。术中行双额冠状切口,右额开颅,牵开额底纵裂,暴露鞍结节-胼胝体膝部区域,根据肿瘤位置可经终板、视交叉-前交通动脉间隙及视交叉前间隙切除肿瘤。结果肿瘤全切除81例(97.6%);保留垂体柄58例(69.9%),未见垂体柄2例(2.4%),因肿瘤已完全侵蚀垂体柄,将其与肿瘤组织一并切除23例(27.7%)。视力改善68例,未改善15例。术后并发症主要为多饮多尿81例,电解质紊乱79例。结论经额底纵裂入路是治疗颅咽管瘤安全有效的方法。

Objective To explore the method and effect of surgery via fronto-basal interhemispheric approach for removing craniopharyngioma. Methods Clinical data of 83 patients who underwent surgery for craniopharyngioma via fronto-basal interhemispheric approach were analyzed retrospectively. Thirty-three patients suffered a recurrence of the tumor. By bifrontal coronal incision, right frontal craniotomy was performed. The longitudinal fissure was detached for exposing the region between the sellar tubercle and genu ...