经胼胝体-透明隔-穹窿间入路显微手术切除第三脑室内颅咽管瘤的疗效分析

Curative effect of microsurgery via transcallosal-septum pellucidum-interforniceal approach on craniopharyngiomas in the third ventricles

目的探讨经胼胝体-透明隔-穹窿间入路显微手术切除第三脑室内颅咽管瘤的疗效。方法回顾性分析2011年2月至2017年9月经胼胝体-透明隔-穹窿间入路显微手术切除的17例第三脑室内颅咽管瘤的临床资料,术前均行对侧侧脑室外引流术。结果肿瘤全切除14例,次全切除2例,部分切除1例。术后出现尿崩症8例,电解质紊乱14例,癫痫1例,高热1例,短期记忆力减退4例。术后长期昏迷1例,死亡1例;15例康复出院。13例术后随访3个月~6年,肿瘤复发2例。结论经胼胝体-透明隔-穹窿间入路为切除第三脑室内颅咽管瘤的有效途径;术前行脑室外引流术有助于减轻脑积水及减少术后并发症。

Objective To investigate the curative effect of microsurgery via transcallosal-septum pellucidum-interforniceal approach on craniopharyngiomas in the third ventricles. Methods The clinical data of 17 patients with craniopharyngiomas in the third ventricles, who underwent preoperative external ventricular drainage and microsurgery via transcallosal-septum pelluciduminterforniceal approach for the tumors in our hospital from February, 2011 to September, 2017, were analyzed retrospectively. Results The total resection of the tumors was achieved in 14 cases, subtotal resection in 2 and partial resection in 1 case. There were diabetes insipidus in 8 patients, electrolyte disturbance in14, epilepsy in 1, hyperpyrexia in 1, short-term memory loss in 4 and coma in 1, and 1 patient died after the microsurgery. Following-up ranging from 3 months to 6 years after the surgery showed that the tumors recurred in 2 patients. Conclusions The transcallosal-septum pellucidum-interforniceal approach is one effective surgical approach for craniopharyngiomas in the third ventricles. The preoperative external intraventricular drainage is helpful to decrease in the hydrocephalus and postoperative complications.