经皮质入路治疗侧脑室肿瘤22例报告

目的侧脑室肿瘤的切除一般采用两种手术方式：经皮质入路或经胼胝体入路.主要讨论采用经皮质入路的手术方式和预后.方法回顾性分析22例侧脑室肿瘤所采用的经皮质入路的术式,同时对经皮质入路的风险、并发症及其预后进行总结.结果手术中没有1例死亡,近全切除6例,大部分切除16例.术后持续性发生癫痫3例,硬膜下积液4例,暂时性视野缺损5例,硬膜下血肿2例,硬膜外血肿3例,脑积水2例.结论对于侧脑室肿瘤,经皮质手术能够提供清晰的手术操作空间并能较好地操作,此术式的关键是知道各皮层的功能解剖,肿瘤的定位和血管供应.了解经皮质入路的优势和缺点能够更有效和安全地切除肿瘤.18例病人（有效率为81%[59.72%,94.81%）]有较好的预后,基本上恢复了正常功能状态,有较低的致残率.

Transcortical Surgery for Lateral Ventricular Tumors:Report of 22 Cases

Objective Tumors of the lateral ventricle can be removed via two major approaches：the transcallosal or the transcortical route.The purpose of this study is to discuss the techniques and outcomes of transcortical surgery for tumors located in the lateral ventricle.Methods 22 consecutive lateral ventricular tumors via the transcortical route were analyzed retrospectively.The risks,complications,and outcomes of this surgical series were summarized.Results No patients died during the operation,the extent of tumor resection was near-total in six cases,gross-total in sixteen.After operation,persistent seizures was found in 3 cases,subdural hygroma in 4 cases,the transient loss of visual field in 5 cases,the subdural hematoma in 2 cases,The majority of the patients in this series（effective 81%[59.72%,94.81%]）had a good outcome,returning to baseline functional status and suffering minimal morbidity.Conclusions As for lateral ventricular tumors,it provides superior superior microsugical working places and flexibility for maneuvering within the lateral ventricle.The key to a suceeful transcortical approach is an understanding of the functional anatomy of eloquent cortex to be broached,the location of the lesion,and its vscular supply.A clear understanding of the advantages and limitations of the transcortical approach makes performing this procedure for resection of large lesions in the ventricle both safe and effective.The majority of the patients in this series（81%）had a good outcome,returning to baseline functional status and suffering minimal morbidity.