The long-term recurrence of Rathke's cleft cysts as predicted by histology but not by surgical procedure
The long-term recurrence of Rathke's cleft cysts as predicted by histology but not by surgical procedure
复制标题
DOI：
10.3171/2015.8.jns151282
复制
发表时间：
2016-10-01
影响因子：
4.1
通讯作者：
Kurisu, Kaoru
中科院分区：
文献类型：
--
作者：
Kinoshita, Yasuyuki;Tominaga, Atsushi;Kurisu, Kaoru
目的有症状的Rathke囊肿经手术治疗后常复发。作者试图澄清手术治疗RCC的长期随访period.METHODS 91个连续RCC患者的随访期超过12个月（平均80.2个月，范围12-297个月）的结果进行了回顾性研究。作者研究了初次手术后MRI上可见囊肿内容物再积聚患者的临床特征和术后病程，并调查了因症状性复发RCCs.Results再次手术患者的数据，36例患者（39.6%）发生囊肿内容物再积聚。在这些患者中，有34例在术后前5年内发生了再积聚。这些患者最初的囊肿通常较大，囊壁有鳞状上皮化生。13例（14.3%）复发症状患者接受了再次手术，13例患者中有10例在术后1年内发生了RCC再积聚。再次手术在第一年（61.5%）或几年后（23.1%）进行。患者最初可能有视觉障碍，囊肿壁可能包括鳞状上皮化生。然而，没有协会之间的发病率观察到的再积累/再手术的RCC和手术的RCCs.CONCLUSIONS的再积累率RCC是高的，在长期的时期，它是与组织学的结果，但不与手术。因此，应进行至少5年的长期监测，以查明和评估任何碾压混凝土的再积累。
OBJECTIVE Patients with symptomatic Rathke's cleft cysts (RCCs) managed by surgical treatment often experience recurrence. The authors attempted to clarify the outcome of surgically treated RCCs over a long-term follow-up period.METHODS Ninety-one consecutive RCC patients with a follow-up period of more than 12 months (mean 80.2 months, range 12-297 months) were retrospectively studied. The authors examined the clinical features and postoperative course of patients who experienced a reaccumulation of cyst contents visible on MRI after the initial surgery, and they investigated data from the patients who underwent reoperation for symptomatic recurrent RCCs.RESULTS Reaccumulation of cyst contents occurred in 36 patients (39.6%). In 34 of these patients, a reaccumulation occurred in the first 5 years after surgery. The initial cysts in these patients were most often large, with squamous metaplasia in the cyst walls. Thirteen patients (14.3%) with recurrent symptoms underwent a reoperation, and 10 of the 13 patients had a reaccumulation of RCCs within the 1st year after surgery. The reoperations were performed in the 1st year (61.5%) or several years later (23.1%). Patients were likely to initially have had a visual disturbance and the cyst walls likely included squamous metaplasia. However, no association was observed between the incidence of reaccumulation/reoperation of RCCs and the surgical procedure for RCCs.CONCLUSIONS The reaccumulation rate of RCC is high in the long-term period, and it is associated with the histological findings but not with the surgical procedure. Long-term monitoring, for a period of at least 5 years, should therefore be conducted to identify and assess any RCC reaccumulation.