微型管状牵开器在内镜脑室外科应用的初步研究

Preliminary study of application of miniature tubular retractor in endoscopic ventricular surgery

目的探讨微型管状牵开器的优点和可行性。方法回顾性分析17例应用微型管状牵开器进行内镜脑室外科手术病人的临床资料。结果 17例病人一次性成功建立工作通道,共有8例病人行镜外操作。病人术前KPS评分中位数为30分,术后1个月KPS评分中位数为80分,较术前明显增加(P=0.035)。术后1个月,预后优良(KPS≥70分)病人13例。术中出血1例;术后一过性脑脊液漏1例,对症治疗后好转;死亡1例。病人均未出现癫疒间发作。结论微型管状牵开器建立手术通道快捷、便利;在遇到出血时或复杂操作时可以排空脑室内的液体,在气体媒介下进行镜外操作。

Objective To explore the advantages and practicability of miniature tubular retractor. Methods Clinical data of 17 patients undergoing endoscopic ventricular surgery with microtubular retractor were analyzed retrospectively. Results The working channels were established successfully in 17 patients at one time. Eight patients underwent extra-endoscopy operation. The median KPS score of the patients before surgery was 30, and the median KPS score of the patients 1 month after the surgery was 80, which was significant higher than scores before surgery(P = 0.035). The good prognosis was observed in 13 patients whose KPS scores were equal to and more than 70. The intraoperative hemorrhage occurred in 1 and transient cerebrospinal fluid leak in 1, who recovered after symptomatic treatment. Death occurred in 1 patient. There was no seizure in all of the patients. Conclusions Miniature tubular retractor is a fast and convenient method for establishing the working channels. When hemorrhage or complicated operation happens,the fluid in the ventricle can be emptied and extra-endoscopy operation is handled by the miniature tubular retractor under the gas medium.