皮质中央区矢状窦旁镰旁脑膜瘤的显微外科治疗

Microsurgical Treatment for Parasagittal and Falcine Meningiomas in Middle Cortex Area

目的探讨皮质中央区矢状窦旁大脑镰旁脑膜瘤的手术方法和治疗效果。方法对手术治疗的35例皮质中央区矢状窦旁大脑镰旁脑膜瘤患者的影像学资料、手术入路、显微手术切除肿瘤的方法及策略进行回顾性分析。结果按Simpson切除标准,Ⅰ级切除24例(68.6%),Ⅱ级切除11例(31.4%)。无手术死亡。随访3个月至5年,4例复发,行二次手术。结论充分的术前影像学评估,合适的手术入路,术中保护好中央沟静脉、处理好上矢状窦和避免脑皮质的损伤,细致的显微操作,能明显提高肿瘤的全切除率,降低复发和其他并发症。

Objective To investigate the operative technique for the parasagittal and falcine meningiomas in the middle cortex areas and its curative effect. Methods The clinical data of 35 patients with parasagittal and falcine meningiomas in the middle cortex areas, who underwent surgery in our hospital from January 2001 to June 2005, were analyzed retrospectively. The clinical data included imaging data, the operative approach, and microsurgery method. Results According to Simpson classification of glioma resection, of the 35 patients, 24 received Grade Ⅰ resection of the tumors and 11 Grade Ⅱ, No patients died from the operation. The followlng-up from 3 to 60 months showed that the meningiomas recurred in 4 patients, who received reoperation, Conclusions The measures including sufficient preoperative imaging evaluation, suitable operative approach, good protection of the vein of central su/cus, excellent management of superior sagittal sinus, avoiding damage to cerebral cortex, and gentle manipulation during the operations can significantly increase the rate of total removal of the tumors, and decrease postoperative recurrence and other complications.