Surgical navigation-assisted endoscopic biopsy is feasible for safe and reliable diagnosis of unresectable solid brain tumors
Surgical navigation-assisted endoscopic biopsy is feasible for safe and reliable diagnosis of unresectable solid brain tumors
复制标题
手术导航辅助内镜活检可安全可靠地诊断不可切除的实体脑肿瘤
DOI：
10.1007/s10143-013-0467-9
复制
发表时间：
2013
期刊：
影响因子：
2.8
通讯作者：
Hirose Y
中科院分区：
文献类型：
--
作者：
5 Nagahisa S;Watabe T;Sasaki H;Nishiyama Y;Hayashi T;Hasegawa M;Hirose Y
立体定向活检已被证实可用于无法通过开颅手术轻易切除的深部病变的组织取样。然而，一些固有的问题，包括无法直接观察病变和难以确认止血限制了它的用途。为了克服这些问题，我们在脑肿瘤活检中使用内窥镜，不仅用于脑室内肿瘤，还用于脑实质内肿瘤。刚性内窥镜与手术导航系统联合使用，通过经皮质途径治疗脑实质内病变。在确定病变轨迹时，没有有用的解剖标志;因此，经皮质手术需要手术导航系统。2007年1月至2012年2月期间，在21例脑实质内病变中尝试了本文所述的内镜手术。所有病例均获得明确诊断，必要时进行遗传分析。在任何病例中均未观察到严重术后出血或神经功能缺损。内窥镜手术提供了一个清晰的目标视图，使其更容易区分肿瘤组织与正常脑组织。此外，内窥镜有助于在手术过程中确认止血。因此，内窥镜活检有可能有助于安全可靠地诊断脑肿瘤。
Stereotactic biopsy has been validated for tissue sampling of deep-seated lesions that cannot be easily resected via open craniotomy. However, some inherent problems including the inability to directly observe the lesion and difficulty in confirming hemostasis limit its usefulness. To overcome these issues, we used the endoscope in brain tumor biopsy, for not only intraventricular tumors but also intraparenchymal tumors. The rigid scope was used in association with a surgical navigation system for intraparenchymal lesions via a transcortical route. There were no useful anatomical landmarks when the trajectory to the lesions was decided; therefore, surgical navigation system was required for the transcortical procedures. The endoscopic procedure described here was attempted in 21 cases of intraparenchymal lesions between January 2007 and February 2012. A definitive diagnosis was obtained in all cases, and genetic analysis was performed when required. Serious postsurgical hemorrhage or neurological deficits were not observed in any cases. Endoscopic surgery provides a clear view of the target and makes it easier to differentiate tumor tissue from normal brain tissue. Moreover, the endoscope helped to confirm hemostasis during the procedure. Thus, endoscopic biopsy has the potential to contribute toward safe and reliable diagnosis of brain tumors.