侵犯上矢状窦的大、巨型旁矢状脑膜瘤的显微外科治疗

Q4 Medicine

中华神经外科杂志 Pub Date : 2020-03-28 DOI:10.3760/CMA.J.CN112050-20190912-00396

G. Lin, Jian-jun Sun, Su Chen, Jing-cheng Xie, C. Ma, Xiao Dong Chen

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The results of clinical follow-up were evaluated by Karnofsky performance score (KPS), and the tumor recurrence was evaluated by imaging follow-up. \n \n \nResults \nAmong the 154 cases, Simpson grade Ⅰ resection was achieved in 112 (72.7%) and grade Ⅱ resection in 42 cases (27.3%). All of them were proved to be meningiomas (World Health Organization grade Ⅰ). The operation time ranged from 30 minutes to 210 minutes (median: 60 minutes), and the length of stay ranged from 5 days to 10 days with an average of 7.2±1.1 days. There was no infection, cerebrospinal fluid leakage, death or permanent aggravation of neurological dysfunction. The patients were followed up for 3 months to 123 months, with an average of 63.5±0.7 months. The KPS score ranged from 80 points to 100 points, with an average of 93.6±0.3 points. Tumor recurrence occurred in 14 patients (9.1%), including 7 in Simpson Ⅰ resection group and 7 in Simpson Ⅱ resection group. 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引用次数: 0

摘要

目的探讨侵袭上矢状窦的巨大矢状旁脑膜瘤的显微外科切除方法及效果。方法回顾性分析2009年5月至2019年5月北京大学第三医院神经外科收治的154例侵犯上矢状窦的巨大矢状旁脑膜瘤的临床资料。肿瘤直径4～8cm，平均5.5±1.2cm，沿中线及纵裂行显微手术切除，马蹄形皮肤切口向颞侧切开。采用Simpson分级系统评估切除程度。临床随访的结果通过Karnofsky性能评分（KPS）进行评估，肿瘤复发通过影像学随访进行评估。结果154例患者中，SimpsonⅠ级切除112例（72.7%），Ⅱ级切除42例（27.3%），均为脑膜瘤（世界卫生组织Ⅰ级）。手术时间从30分钟到210分钟（中位数：60分钟），住院时间从5天到10天，平均7.2±1.1天。没有感染、脑脊液渗漏、死亡或神经功能障碍的永久性加重。随访3个月～123个月，平均63.5±0.7个月。KPS评分从80分到100分不等，平均为93.6±0.3分。肿瘤复发14例（9.1%），其中SimpsonⅠ组7例，SimpsonⅡ组7例。结论侵袭上矢状窦的巨大矢状旁脑膜瘤可采用SimpsonⅠ级显微外科手术切除，有助于降低复发率。关键词：脑膜瘤；显微外科；治疗结果；矢状窦；大型和巨型

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Microsurgical treatment of large and giant parasagittal meningioma invading the superior sagittal sinus

Objective To investigate the method and effect of microsurgical removal of large and giant parasagittal meningioma invading the superior sagittal sinus. Methods The clinical data of 154 cases with large and giant parasagittal meningioma invading the superior sagittal sinus admitted to Department of Neurosurgery, Peking University Third Hospital from May 2009 to May 2019 were retrospectively analyzed. The diameter of the tumors ranged from 4 cm to 8 cm, with an average of 5.5±1.2 cm. Microsurgical resection was carried out along the midline and longitudinal fissure with a horse-shoe shaped skin incision turning to the temporal side. The degree of resection was evaluated by Simpson grading system. The results of clinical follow-up were evaluated by Karnofsky performance score (KPS), and the tumor recurrence was evaluated by imaging follow-up. Results Among the 154 cases, Simpson grade Ⅰ resection was achieved in 112 (72.7%) and grade Ⅱ resection in 42 cases (27.3%). All of them were proved to be meningiomas (World Health Organization grade Ⅰ). The operation time ranged from 30 minutes to 210 minutes (median: 60 minutes), and the length of stay ranged from 5 days to 10 days with an average of 7.2±1.1 days. There was no infection, cerebrospinal fluid leakage, death or permanent aggravation of neurological dysfunction. The patients were followed up for 3 months to 123 months, with an average of 63.5±0.7 months. The KPS score ranged from 80 points to 100 points, with an average of 93.6±0.3 points. Tumor recurrence occurred in 14 patients (9.1%), including 7 in Simpson Ⅰ resection group and 7 in Simpson Ⅱ resection group. There was significant difference in recurrence rate between the 2 groups (χ2=4.01, P<0.05). Conclusion Simpson grade Ⅰ microsurgical resection can be pursued for large and giant parasagittal meningioma invading the superior sagittal sinus which helps minimize the recurrence rate. Key words: Meningioma; Microsurgery; Treatment outcome; Sagittal sinus; Large and giant

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来源期刊

中华神经外科杂志 Medicine-Surgery

CiteScore

0.10

自引率

0.00%

发文量

10706

期刊介绍： Chinese Journal of Neurosurgery is one of the series of journals organized by the Chinese Medical Association under the supervision of the China Association for Science and Technology. The journal is aimed at neurosurgeons and related researchers, and reports on the leading scientific research results and clinical experience in the field of neurosurgery, as well as the basic theoretical research closely related to neurosurgery.Chinese Journal of Neurosurgery has been included in many famous domestic search organizations, such as China Knowledge Resources Database, China Biomedical Journal Citation Database, Chinese Biomedical Journal Literature Database, China Science Citation Database, China Biomedical Literature Database, China Science and Technology Paper Citation Statistical Analysis Database, and China Science and Technology Journal Full Text Database, Wanfang Data Database of Medical Journals, etc.