Endoscopic stereotactic interventions in the treatment of brain lesions.
Endoscopic stereotactic interventions in the treatment of brain lesions.
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内窥镜立体定向干预治疗脑损伤。
DOI：
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发表时间：
1994
期刊：
影响因子：
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通讯作者：
F. Moure
中科院分区：
文献类型：
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作者：
L. Zamorano;C. Chavantes;F. Moure
图像引导的立体定位是一种准确和安全的方法，使用图像数据的计算机重建将治疗引导到在二维（2D）多平面或三维（3D）透视图中定义的靶体积。立体定向技术的主要局限性是缺乏术中可视化和对手术的直接监测，以及在治疗脑室内病变时囊性病变减压或脑脊液抽吸后颅内坐标的变化。内窥镜激光立体定向术（ELS）是将软硬结合内窥镜和Nd-YAG激光整合到3D-2D多平面图像引导立体定向手术中。ELS的主要优势包括：微创（钻孔或小开颅手术）、术中直接可视化、止血、排空或切除评估以及颅内腔或脑室的广泛探查。ELS已用于152例临床病例的治疗，包括深部和皮质下颅内病变的活检、抽吸、切除和内部减压，以及不同类型的开窗手术。图像引导结合内窥镜技术可为治疗小型实性、囊性和脑室内病变以及开窗术提供传统神经外科手术的安全、准确的替代方案。
Image-guided stereotaxis is an accurate and safe method of directing therapy to target volumes defined in two-dimensional (2D) multiplanes or three-dimensional (3D) perspectives using computer reconstruction of image data. The major limitations of stereotactic techniques are a lack of intraoperative visualization and direct monitoring of the procedures, and changes of intracranial coordinates after decompression of cystic lesions or aspiration of cerebrospinal fluid in the management of intraventricular lesions. Endoscopic laser stereotaxis (ELS) involves integration of rigid-flexible endoscopy and Nd-YAG laser to 3D-2D multiplanar image-guided stereotactic procedures. The major advantages of ELS include: minimally invasive (burrhole or small craniotomy surgery), direct intraoperative visualization, hemostasis, evacuation or resection assessment, and wide exploration of intracranial cavities or ventricles. ELS has been used in the management of 152 clinical cases including biopsy, aspiration, resection and internal decompression of deep and subcortical intracranial lesions, and different types of fenestration procedures. Image-guidance combined with endoscopic techniques may offer a safe, accurate alternative to conventional neurosurgical procedures in treating small solid, cystic, and intraventricular lesions as well as fenestration procedures.