不同手术入路治疗透明隔肿瘤效果的比较

Comparison of Postoperative Results in Terms of Operative Lesions among Treatments via Different Approaches in Patients with Septum Pellucidum

目的比较额部皮质造瘘(n=19)、额中回脑沟入路(n=11)、额部胼胝体入路(n=11)3种手术入路治疗41例透明隔肿瘤的临床效果。方法对3种不同的手术入路术中正常脑组织切除范围、肿瘤的切除程度、术后致残率进行统计学分析。结果3种手术入路之间肿瘤切除程度比较差异无统计学意义,术中脑组织的切除范围、术后致残率比较差异有统计学意义(P<0.01,P<0.05);额部皮质造瘘组对脑组织损伤最大、致残率最高;额部胼胝体入路脑组织损伤最小、致残率最低,其次是额中回脑沟入路。结论额部胼胝体入路、额中回脑沟入路治疗透明隔肿瘤符合微创手术理念;对于透明隔肿瘤以首选额部胼胝体入路为宜。

Objective To compare the clinical results in terms of operative lesions among treatments via different approaches which include frontal transcortical(n=19), frontal intergyral(n=11), and frontal transcallosal(n=11) approaches respectively. Methods The removal extent of brain tissue, the removal degree of tumer and the incidence of postoperative morbility were analyzed with statistical method. Results No significant difference among the removal degree of lesions, but significant difference among the removal extent of brain tissue and the rate of postoperative morbility. The highest postoperative morbility rate occur with the patients operated via frontal transcortical approach (55.6%), but the lowest postoperative morbility rate occurs with the patients via frontal transcallosal approach (9.1%). The postoperative morbility rate of patients via frontal intergyral approach (18.2%) is less than that operated via frontal transcortial approach; but higher than that operated via frontal transcallosal approach. Conclusion Operational treatment of the septum pellucidum via transcallosal approach and intergyral approach accord with the microinvasive concept. It is appropriate to select transcallosal approach in frontal part as the first choice for septum pellucidum in terms of operative lesions.