椎管内胚胎残余组织肿瘤的显微手术治疗(附21例分析)

Microsurgery for intraspinal tumors of embryonal origin:report of 21 cases

目的分析椎管内胚胎残余组织肿瘤(ITEO)的手术治疗技巧和注意事项。方法总结21例病人的神经影像学、手术治疗和病理检查资料。其中表皮样囊肿、皮样囊肿和畸胎瘤共15例,占71.4%。均采用显微手术切除病变,注意保护神经组织。2例术后给予放疗。结果肿瘤全切17例(81.0%),次全切除4例(19.0%)。术后神经功能均有不同程度的改善。随访7个月￣5年,1例(4.8%)复发。结论采用显微手术全切病变是治疗ITEO的最好选择。不能全切者可行放疗,有助于防止肿瘤复发。

Objective To stud y the surgical technique and key points for intraspinal tumors of embryonal origin （ITEO）. Methods Twenty-one cases of ITEO were retrospectively studied for the materials on neural imaging, surgical treatment, and pathological examination. Fifteen out of 21cases （71.4%） were diagnosed as epidermoid cyst, dermoid cyst and teratoma and underwent microsurgery. Neural tissue was protected intraoperatively. Two patients received postoperative routine radiotherapy. Results Total tumor removal was achieved in 17 cases （81%） and subtotal in 4 （19.0%）. The function of neural system was improved in all the patients postoperation. Tumor recurrence was found in 1 case during the 7 months to 5 years of follow-up. Conclusions The best treatment choice for ITEO is total removal of the lesions by mierosurgery. Radiotherapy can help to prevent tumor recurrence in the patients who can not undergo total tumor removal.