翼点入路显微手术切除颅咽管瘤

Microsurgery through pterional approach for craniopharyngiomas

目的探讨经翼点入路切除颅咽管瘤的手术方法及效果。方法13例颅咽管瘤患者均采用经右侧翼点入路手术,合理利用四个手术间隙切除肿瘤。结果11例肿瘤达到全切,1例囊实性和1例实性肿瘤次全切除(术后分别行γ-刀治疗);1例术后9d死亡。随访6月～2.4年,12例均未见肿瘤复发。结论应用显微外科技术经翼点入路可满意地切除颅咽管瘤,术后辅以放疗或γ-刀治疗能有效地延长患者生存时间,减少复发。

Objective To explore the skill of microsurgery through the pterional approach for craniopharyngiomas and its curative effect on the craniopharyngiomas. Methods The microsurgery through the right pterional approach was performed in 13 patients with craniopharyngiomas. The four operative gaps were reasonably used for the resection of the tumors during the microsurgery. Results The total removal of the tumors was achieved in 11 patients and the subtotal removal in 1 patient with cystic tumor and 1 patient with solid tumor, whom received gamma knife radiosurgery for the residual resection. One patients died 9 days after the operation. The following up from 6 monthes to 2.4 years showed that the tumors did not recurred in 12 patients. Conclusions The craniopharyngiomas may be satisfactorily resected by the microsurgery through pterional approach. The prognoses are good in the patients with craniopharyngiomas undergoing the total removal of the tumors or subtotal removal and the postoperative radiotherapy or gamma knife treatment.