3种手术入路治疗侧脑室前部肿瘤效果的比较

Comparison of clinical results of tumors at the anterior portion of lateral ventricles via different approaches

目的比较额部皮质造瘘、额中回脑沟入路、额部纵裂胼胝体入路3种手术入路治疗46例侧脑室额角及体部肿瘤的临床效果。方法对3种不同的手术入路术中肿瘤的切除程度、术后并发症发生率、脑室外引流时间进行统计学分析。结果3种手术入路之间肿瘤切除程度无统计学差异,额中回脑沟入路组、额部纵裂胼胝体入路组术后并发症发生率低于额部皮质造瘘组,纵裂胼胝体入路组脑室外引流时间明显低于额部皮质造瘘组。结论侧脑室前部肿瘤多应选择纵裂胼胝体入路,如纵裂引流静脉粗大,分离困难,则可选择额中回脑沟入路。此外,对于直径大于7cm,且与侧脑室上壁粘连紧密的肿瘤也应选择额中回脑沟入路。

[Objective] To compare the clinical results of tumors at the anterior portion of lateral ventricles via frontal transcortical, frontal transsulcal and transcallosal approaches respectively. [Methods] Resection percentage, postoperative morbility and days of ventricular drainage of three groups of cases were compared. [Results] No significant difference of resection percentage but significant difference of postoperative morbility and days of ventricular drainage between frontal transcortical and transsulcal and transcallosal approaches. [Conclusion] Transcallosal approach should be taken in the surgery of tumors at the anterior portion of lateral ventricles. Difficulties of separating longitudinal fissure due to large drainage veins and tumors larger than 7 cm lead to selection of transsulcal approach.