CAJ | 학술논문

目的探讨儿童丘脑胶质瘤的临床特征和显微外科治疗.方法总结49例儿童丘脑胶质瘤的临床特征,分别采取经胼胝体-穹窿间入路、胼胝体-侧脑室入路、经顶或顶枕-侧脑室(经三角区)入路、经额-侧脑室入路、经颞皮层入路、经颞下小脑幕入路进行显微外科治疗.结果初次手术中,近全切除23例,大部切除17例,部分切除9例,围手术期死亡2例.39例获得随访,16例存活,其中15例生活可以自理.结论手术是儿童丘脑胶质瘤的首选治疗,根据肿瘤的位置、生长方向及术者经验采取合理的手术入路,尽可能减少重要结构的损伤,减少术后并发症.
목적 탐토인동구뇌효질류적림상특정화현미외과치료.방법 총결49례인동구뇌효질류적림상특정,분별채취경변지체-궁륭간입로、변지체-측뇌실입로、경정혹정침-측뇌실(경삼각구)입로、경액-측뇌실입로、경섭피층입로、경섭하소뇌막입로진행현미외과치료.결과 초차수술중,근전절제23례,대부절제17례,부분절제9례,위수술기사망2례.39례획득수방,16례존활,기중15례생활가이자리.결론 수술시인동구뇌효질류적수선치료,근거종류적위치、생장방향급술자경험채취합리적수술입로,진가능감소중요결구적손상,감소술후병발증.
Objective To investigate the clinical features and microsurgical strategies of thalamic gliomas in children.Method The clinical features of thalamic gliomas in the 49 children were summarized and all the tumors were removed through various approaches,such as transcallosal- interforniceal,transcallosal - ventricular,transparietal - ventricular or transoccipital - ventricular ( transatrium of lateral ventricle),transfrontal- ventricular,transtemporal cortical and subtemporal transtentorial approaches by means of microsurgical techniques.Results At the initial operations,gross - total,sub - total and partial removal of the tumors were achieved in 23,17,9 cases respectively,and there were 2 death cases after operation.39 children were followed up,and 16 patients of them were still alive,and 15 children were independent.Conclusions As the prior choice of initial therapies in treating children with thalamic gliomas,appropriate surgical approaches should be choosed according to the tumor location,extensive direction and the surgeon's personal experience,furthermore,the important adjacent structures should be protected as much as possible in order to decrease the relative post -operative complications.