神经内镜经幕下小脑上治疗松果体区肿瘤15例

Experience in neuroendoscopy for the treatment of pineal region tumors via the supracerebellar infratentorial approach: An analysis of 15 cases

目的 总结神经内镜经幕下小脑上手术入路治疗松果体区肿瘤的相关经验。方法 分析解放军第960医院2017年1月-2020年12月收治的15例患者,均由神经内镜经幕下小脑上治疗松果体区肿瘤。结果 通过神经内镜抵近、多方向观察,精细操作,15例的肿瘤均手术全切,其中6例术中快速病理显示生殖细胞瘤,术中在神经内镜下全切肿瘤,后期转肿瘤科继续治疗。其中13例术前合并不同程度脑积水,术后均缓解,后期均未行脑室腹腔分流术。15例术后半年随访,预后均良好。结论 松果体区肿瘤在神经内镜下经幕下小脑上手术入路,经自然通道,能避免不必要损伤,通过内镜手术治疗既能解决脑积水问题,又能安全有效切除肿瘤,减少手术并发症发生。

ObjectiveTo investigate the experience in neuroendoscopy for the treatment of pineal region tumors via the supracerebellar infratentorial approach.MethodsA retrospective analysis was performed for 15 patients who were admitted to 960 Hospital of PLA from January 2017 to December 2020,and all patients underwent neuroendoscopy for the treatment of pineal region tumors via the supracerebellar infratentorial approach.ResultsTotal tumor resection was achieved for all patients by neuroendoscopy through close resection,observation from multiple directions,and meticulous operation. Rrapid intraoperative pathology showed that 6 patients had germinoma,which was completely removed under neuroendoscopy,and the patients were transferred to department of oncology for further treatment. Of all patients,13 had varying degrees of hydrocephalus before surgery,which was relieved after surgery,and no ventriculoperitoneal shunt surgery was performed in the later period of time. All 15 patients were followed up for half a year after surgery and had good prognosis.Conclusions Neuroendoscopy for pineal region tumors via the supracerebellar infratentorial approach can avoid unnecessary damage,and it can not only remove hydrocephalus,but also achieve safe and effective tumor resection to reduce the incidence rate of surgical complications.