神经内镜联合显微镜的双镜技术在松果体区脑膜瘤显微手术中的应用

Combined endoscopic and microsurgical resection of pineal region meningiomas by modified Poppen approach

回顾性分析2018年1月到2021年3月苏州大学附属第一医院利用改良枕部经小脑幕入路(Poppen入路),神经内镜联合显微镜切除的松果体区脑膜瘤的病例资料。肿瘤全切10例,无死亡病例。术后病理学诊断均为脑膜瘤。随访期间肿瘤无进展10例,术后行放疗4例。术中行脑室外引流8例,随访期间行脑室腹腔分流术0例。术后患者症状好转9例,症状较术前无明显变化1例,术后症状恶化或出现新发症状0例。改良Poppen入路下通过神经内镜联合显微镜的双镜技术在进行松果体区脑膜瘤显微手术切除时,通过内镜能直视大脑深静脉系统,有效提升肿瘤的全切率,减少大脑深静脉系统损伤可能,并降低手术并发症的发生率。

To retrospectively analyze the clinical data of patients with pineal region meningioma.All the patients underwent combined endoscopic and microsurgical procedure by modified Poppen approach(double-scopic technique)between January 2018 and March 2021 in the Department of Neurosurgery of the First Affiliated Hospital of Soochow University.A total tumor resection was achieved in all the patients without deaths.All the pineal region meningiomas were pathologically confirmed.During the follow-up period,none of the 10 patients experienced tumor progression,and 4 of patients were treated by radiotherapy after surgery.The external ventricular drainage was performed in 8 cases intraoperatively,and no case underwent the ventriculoperitoneal shunt during the follow-up period.The clinical symptoms of 9 cases were improved,1 case had no improvement,and no patients presented deteriorated symptoms.Combined endoscopic and microsurgical surgery resection of pineal region meningiomas by modified Poppen approach helped the surgeons directly observe the cerebral deep vein systems in pineal region with endoscope and significantly enhance the total resection rate of pineal region meningiomas,thereby decreasing the damage of cerebral deep vein systems in pineal region and reducing the incidence of surgical complications.