CAJ | 학술논문

目的经额部纵裂终板入路切除鞍区和视交叉后部肿瘤,前交通动脉切断后以利于肿瘤切除,探讨切断前交通动脉的安全性.方法采用经额部纵裂入路切除鞍区和视交叉后部肿瘤14例,术中切断前交通动脉以利于肿瘤的显露和切除.结果 8例颅咽管瘤全切除.3例视神经胶质瘤:1例大部切除,1例近全切除,1例全切除.1例嗅沟脑膜瘤近全切除,1例鞍背脑膜瘤大部切除.1例生殖细胞瘤做活检.14例没有手术死亡.1例前交通动脉的宽度为3 mm被切断,术后双侧大脑前动脉区和右侧基底节区缺血,病人呈浅昏迷状态.余13例的前交通动脉宽度4～10 mm,切断后没有缺血改变.结论经额部纵裂终板入路,当前交通动脉妨碍肿瘤的显露和切除时,且前交通动脉的宽度在4咖以上时.可以安全地切断前交通动脉.
목적 경액부종렬종판입로절제안구화시교차후부종류,전교통동맥절단후이리우종류절제,탐토절단전교통동맥적안전성.방법 채용경액부종렬입로절제안구화시교차후부종류14례,술중절단전교통동맥이리우종류적현로화절제.결과 8례로인관류전절제.3례시신경효질류:1례대부절제,1례근전절제,1례전절제.1례후구뇌막류근전절제,1례안배뇌막류대부절제.1례생식세포류주활검.14례몰유수술사망.1례전교통동맥적관도위3 mm피절단,술후쌍측대뇌전동맥구화우측기저절구결혈,병인정천혼미상태.여13례적전교통동맥관도4～10 mm,절단후몰유결혈개변.결론 경액부종렬종판입로,당전교통동맥방애종류적현로화절제시,차전교통동맥적관도재4가이상시.가이안전지절단전교통동맥.
Objective The use of a frontal interhemispheric approach with division of the anterior communicating artery (ACoA) for removal of sellar and retrachiasmatic areas tumors. Whether or not this division can provide wide operative field and be safe. Method From Jan 2001 to Oct 2006, 14 cases of sellar and retrachiasmatic areas tumors undertook surgery with division of the ACoA. All cases underwent the frontal interhemispheric approach to achieve good excision of the tumors. Results 8 craniopharyngiomas were totally removed. 3 optic chiasmtic gliomas were tottally, subtotally, and partially removed respectively.One olfactory meningoma was subtotally removed, one sella dorsum meningoma was partially removed. One germinoma was biopsy. One case of chiasmtic glioma with division of the 3 nun width of the ACoA was stupor postoperatively. With the ACoA over 4 mm width, there were no ischemie symptoms with the division of ACoA, postoperatively. Conclusions When the ACoA limited to the operative exposure and over 4 mm width, the artery cotdd be divided safely.