Microscopic Resection of Intracranial Lesions with Tubular Retractor of Plastic Syringe: A Single-Center Experience of 157 Cases.

Asian journal of neurosurgery Pub Date : 2025-05-16 eCollection Date: 2025-09-01 DOI:10.1055/s-0045-1809154
Mohan Karki, Manish Vaish, Yaspal Singh Bundela, Hrishikesh Chakrabartty, Yam Bahadur Roka, Dipanshu Narula, Rakesh Pandey
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Abstract

Objective: Deeply located intracranial lesions such as intraparenchymal and intraventricular lesions are surgically challenging and associated with unavoidable complications such as seizure, surgical bed hematoma, and brain contusion caused by traction. The objective of this study is to evaluate the safety and effectiveness of the microscopic tubular retractor of a plastic syringe for the resection of deeply located brain lesions.

Materials and methods: We retrospectively studied 157 patients with deep-seated intracranial lesions who underwent microscopic resection with the help of a tubular retractor made of a plastic syringe and Teflon introducer between January 2018 and January 2024 in a tertiary hospital. All deep-seated lesions were such as neurocytoma, lymphoma, ependymoma, colloid cysts, metastatic brain tumors, astrocytoma, and meningiomas. We evaluated all patients postoperatively with computed tomography (CT) scan on the first/second day of surgery. The amount of blood loss, the complications, and the mortality rate were recorded.

Results: There were 104 males and 53 females with a mean age of 54.13 (range: 15-80) years. Gross total resection was obtained in 85.35% and subtotal in 14.65% of patients. Complications such as surgical bed hematoma in 5.73%, seizure in 3.18%, weakness in 2.54%, and contusion in 3.82% of patients were noted. The blood loss varied from 30 to 500 mL (average, 100 mL). The mortality rate was observed in 2.54% of all patients. Follow-up ranged from 1 to 25 months (average, 10 months).

Conclusion: Plastic syringe tubular retractor with Teflon introducer system is safe and effective for the treatment of deeply located intracranial lesions in terms of low morbidity and excellent rate of resection.

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单中心塑料注射器管状牵开器显微切除颅内病变157例体会。
目的:位于深部的颅内病变,如脑实质内和脑室内病变,具有手术挑战性,并伴有不可避免的并发症,如癫痫发作、手术床血肿和牵引引起的脑挫伤。本研究的目的是评估塑料注射器显微管状牵开器用于切除深部脑病变的安全性和有效性。材料和方法:回顾性研究某三级医院2018年1月至2024年1月期间,157例深部颅内病变患者在塑料注射器和特氟龙引入器制成的管状牵开器的帮助下进行显微切除。所有深层病变包括神经细胞瘤、淋巴瘤、室管膜瘤、胶质囊肿、转移性脑瘤、星形细胞瘤和脑膜瘤。我们在手术的第一天/第二天通过计算机断层扫描(CT)对所有患者进行术后评估。记录出血量、并发症及死亡率。结果:男性104例,女性53例,平均年龄54.13岁(15 ~ 80岁)。总切除率为85.35%,次切除率为14.65%。并发手术床血肿5.73%,癫痫3.18%,虚弱2.54%,挫伤3.82%。出血量从30到500毫升不等(平均100毫升)。死亡率为2.54%。随访1 ~ 25个月(平均10个月)。结论:塑料注射器管式牵开器配合特氟龙引入系统治疗颅内深部病变安全有效,发病率低,切除率高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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