CAJ | 학술논문

目的探讨直切口小骨窗斜行切开小脑幕技术切除儿童松果体区肿瘤的效果.方法总结2008年1月至2011年10月环湖医院收治9例应用改进Poppen入路手术的松果体区肿瘤患儿.统计肿瘤全切除率、并发症发牛率和开关颅时间.结果肿瘤显微镜下全切除率为77.8％,桥静脉损伤率为11.1％,一过性同向性偏盲发生率为22.2％,开关颅时间平均(25.4±4.4) min.全切除病例脑积水缓解率100％,1例取活检后行第三脑室底造瘘术,无脑室-腹腔分流病例,无手术死亡病例.结论改进Poppen入路为松果体区肿瘤切除手术提供了充足的视野和操作空间,使手术安全性更高,并发症发生率更低.
목적 탐토직절구소골창사행절개소뇌막기술절제인동송과체구종류적효과.방법 총결2008년1월지2011년10월배호의원수치9례응용개진Poppen입로수술적송과체구종류환인.통계종류전절제솔、병발증발우솔화개관로시간.결과 종류현미경하전절제솔위77.8％,교정맥손상솔위11.1％,일과성동향성편맹발생솔위22.2％,개관로시간평균(25.4±4.4) min.전절제병례뇌적수완해솔100％,1례취활검후행제삼뇌실저조루술,무뇌실-복강분류병례,무수술사망병례.결론 개진Poppen입로위송과체구종류절제수술제공료충족적시야화조작공간,사수술안전성경고,병발증발생솔경저.
Objective To evaluate the efficiency and safety of the surgical procedure to deal with the tumors in pineal region of children.Methods 9 children who suffered from the pineal region tumors received the modified Poppen approach in TianjinHuanhu hospital from January 2008 to October 2011.Three main techniques were included in the reformative Poppen approach:straight incision of scalp starting from the external occipital jut and then extending just between the lines of transversesinus and superiorsagittal sinus for 5 ～ 7 cm,a little rounded skull window with a diameter of 3.5 cm,and instead of along the straight sinus as the classical Poppen approach,the tentorial was incised just from the confluence of sinus and then agley go to the tentorial edge.The results were evaluated with indexes such as the rate of gross total resection (GTR) of tumors,the complication derived from the approach,the duration between cranial opening and closing.Results The GTR was 77.8％.The rate of bridging vein injury was 11.1％.The homonymous hemianopia rate was 22.2％.The duration between cranial opening and closing was ( 25.4 ± 4.4 ) mins.There was no death.Conclusions The modified Poppen approach could offer enough visual field and space to resect the pineal region tumorsof children drasticallyand safely.