Poppen入路显微切除松果体区肿瘤35例临床分析

Microsurgical Removal of Pineal Region Tumors Via Poppen Approach: Clinical Analysis of 35 Cases

目的探讨松果体区肿瘤经Poppen入路的显微外科治疗方法及手术技巧。方法回顾性分析深圳市第二人民医院神经外科2002年2月至2012年12月收治的35例经Poppen手术入路显微切除的松果体区肿瘤患者的临床资料。结果全切除27例,次全切6例,部分切除2例。其中生殖细胞瘤9例,脑膜瘤9例,蛛网膜囊肿5例,成熟畸胎瘤5例,表皮样囊肿2例,胶质瘤2例,血管网织细胞瘤2例,转移瘤1例。术后无1例发生视野缺损,平均住院27d,均恢复良好出院,所有患者出院时KPS评分平均(88.0±5.9)分,均较术前的(78.0±8.7)分明显提高。结论 Poppen入路显微外科手术治疗松果体区肿瘤路径短、损伤小、损伤深静脉可能性小、肿瘤切除满意,是治疗松果体区肿瘤的理想入路。

Objective To investigate the microsurgical treatment for tumors in the pineal region and the surgical skills.Methods Clinical data of 35 patients who were admitted to the Department of Neurosurgery,the Shenzhen Second People＇s Hospital from February 2002 to December 2012,and received microsurgical resection of pineal region tumors via the Poppen approach were retrospectively analyzed.Results Tumors were totally removed in 27patients,subtotally in 6and partially in 2.There were 9 germinomas,9 meningiomas,5 arachnoid cysts,5 mature teratomas,2 epidermoid cysts,2 gliomas,2 angioreticulomas,and 1 metastatic tumor.No visual field defects occurred postoperatively.All patients recovered well and had an average of 27 days in hospital stay.The average KPS scores at discharge were（88.0±5.9）,significantly greater than those on admission（78.0±8.7）.Conclusion Microsurgical treatment via Poppen approach has the advantages of short path,less injury,low possibility in damaging the deep vein,and satisfactory removal of the tumor.It is an ideal procedure in the management of patients with pineal region tumors.