神经内镜腔内操作切除脑室内肿瘤

Pure neuroendoscopic intraventricular tumor resection

目的探讨采用神经内镜腔内操作技术切除脑室内肿瘤的手术体会，并评价其优缺点。方法回顾性分析南方医科大学南方医院神经外科2012年3月至2014年12月收治的8例脑室内肿瘤在神经内镜腔内操作下全切除手术的临床资料。本组脑室内肿瘤的最大径为2．1cm。临床表现为头痛4例，头晕1例，1例为头部外伤后检查发现，1例为体检时发现，1例出生前产检时发现脑积水。CT及MRI检查提示8例脑室内有占位病变，其中3例肿瘤位于侧脑室前角，5例位于侧脑室三角部。所有患者均采用神经内镜腔内操作技术切除肿瘤。结果8例脑室内肿瘤均达到完全切除，病理检查证实脑膜瘤3例，脉络丛乳头状瘤5例。术后颅内感染1例，余无其他并发症。术后随访3个月至3年，影像学检查均未见复发。结论神经内镜腔内操作下脑室内肿瘤切除术，具有损伤小、恢复快、并发症少的优点，适合切除小型脑室内肿瘤。

Objectives To investigate the operation experiences of resection of intraventricular tumors with the neuroendoscopic technique and to evaluate its advantages and disadvantages. Methods From March 2012 to December 2014, the clinical data of 8 patients with cerebral ventricular tumor resected completely under the neuroendoscopic cavity operation at the Department of Neurosurgery, Nanfang Hospital, Southern Medical University were analyzed retrospectively. The maximal diameter of the cerebral ventricular tumors was 2.1 cm in this group. The clinical manifestations were headache in 4 cases, and dizziness in 1 case. One patient was found after head trauma, 1 was found during the physical examination, and 1 was found hydrocephalus during the prenatal examination. CT and MRI revealed that 8 patients had intraventricular occupying lesions, the tumors of 3 cases were located in the antecornu and 5 were located in the lateral ventricle trigone. All patients used the neuroendoscopic cavity operation technique to remove the tumors. Results The intraventricular tumors of 8 patients were resected completely. The pathological examination confirmed that 3 patients had meningiomas and 5 had choroid plexus papilloma. One patient had postoperative intracranial infection, and others did not have any complications. They were followed up for 3- 36 months after procedure. No recurrence was found in imaging examination. Conclusions The pure neuroendoseopic intraventrieular tumor removal has the advantages of less injury, quick recovery, and less complications. It is suitable for resection of small cerebral ventricular tumors