[Clinical application and future prospect of neuroendoscopic surgery].
[Clinical application and future prospect of neuroendoscopic surgery].
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神经内窥镜手术的临床应用及未来展望[J].
DOI：
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发表时间：
1999
期刊：
影响因子：
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通讯作者：
S. Oi
中科院分区：
文献类型：
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作者：
S. Oi
本文就神经内镜手术的临床应用及未来的前景作一综述。在历史发展趋势中，强调神经内镜手术已成为颅内病变微创治疗的主要或主导手段之一。目前可用的器械包括使用三种不同类型内窥镜的手术：刚性杆、可操纵/柔性纤维杆和半刚性杆。使用硬杆或纤维杆镜，可使用镊子、激光、微球和其他精细器械。神经内镜手术的适应症已扩展至几乎所有神经外科手术，因为“内镜辅助”手术更多地应用于显微神经外科手术（内镜辅助显微手术）。“纯神经内镜手术”的现实适应症包括脑脊液（CSF）通路重建，如第三脑室造口术、中隔造口术、孔重建、中隔开窗术;肿瘤/囊性病变切除或活检，主要在脑室内区域;以及涉及脑实质（脑内血肿）、脑室/（脑室内血肿）或硬膜下腔（硬膜下血肿）的血肿切除。脑实质内或脑池内深部病变可作为“纯神经内镜手术”的现实适应证。神经内镜手术将在21世纪的“微创神经外科手术”中发挥重要作用。
The clinical application and future prospect of neuroendoscopic surgery are described. In the historical trend, it is emphasized that the neuroendoscopic surgery has become one of the major or leading procedures in "minimally-invasive approaches" to the intracranial lesions. The presently-available instrument include procedures using an endoscope of three different types: rigid-rod, steerable/flexible-fiber-rod and semi-rigid-rod. To use a rigid-rod or fiber-rod scope, it is available to apply forceps, laser, a microballoon and other fine instruments. The indication for neuroendoscopic surgery has been expanded to almost all neurosurgical procedures, as "endoscope-assisted" procedures are applied more to micro neurosurgical procedures (endoscope-assisted microsurgery). The realistic indication for "pure neuroendoscopic surgery" includes reconstruction of cerebrospinal fluid (CSF) pathway such as third ventriculostomy, septostomy, foramen reconstruction, fenestration of septation; removal or biopsy of tumor/cystic lesion, mainly in the intraventricular regions; and removal of hematoma involving the cerebral parenchyma (intracerebral hematoma), ventricles/(intraventricular hematoma) or subdural space (subdural hematoma). The intraparenchymal or deep-seated intracisternal lesions can be the realistic indication for "pure neuroendoscopic surgery" when the instrument are further developed in future. Neuroendoscopic surgery will play a promising and major role in the "minimally-invasive neurological procedure" in the 21st century.