Resection of Intraventricular Tumors in Children by Purely Endoscopic Means
Resection of Intraventricular Tumors in Children by Purely Endoscopic Means
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DOI：
10.1016/j.wneu.2015.11.052
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发表时间：
2016-03-01
影响因子：
2
通讯作者：
Harter, David H.
中科院分区：
文献类型：
--
作者：
Hidalgo, Eveline Teresa;Ali, Aryan;Harter, David H.
目的：神经内镜越来越多地用于脑室内肿瘤的治疗。内窥镜在诊断性活检中的作用是公认的。这些技术的扩展可能允许明确切除脑室内肿瘤。我们报告的可行性和结果的内窥镜切除术选择脑室内肿瘤children.METHODS：11例儿童实性脑室内肿瘤谁接受肿瘤切除术的临床特点进行了审查。结果：12例中11例（92%）获得了大体全切除。肿瘤最大直径范围为9 - 26 mm（平均16.6 mm）。病理结果包括室管膜下巨细胞星形细胞瘤、室管膜瘤、非生殖细胞瘤和毛细胞星形细胞瘤。平均随访35个月（范围：10-109个月）。所有患者在手术后均恢复至其神经系统基线。局部复发1例，远处复发1例。在1例患者中，发生了暂时性术中颅内压升高，无临床意义。本系列无永久性发病或死亡。5例患者术前存在脑积水，并单独进行肿瘤切除或额外进行内镜下第三脑室造口术。没有病人需要脑室腹腔shunt.CONCLUSIONS：神经内窥镜大体全切除术的实性脑室内肿瘤是一个安全和有效的程序，精心挑选的儿科患者。
OBJECTIVE: Neuroendoscopy is increasingly being used in the management of intraventricular brain tumors. The role of endoscopy in diagnostic biopsy is well established. Expansion of these techniques may allow for definitive resection of intraventricular tumors. We report the feasibility and outcomes of endoscopic resection of select intraventricular tumors in children.METHODS: The clinical characteristics of 11 children with solid intraventricular tumors who underwent tumor resection were reviewed. Twelve procedures were performed.RESULTS: Gross-total resection was achieved in 11 of 12 cases (92%). Maximal tumor diameter ranged from 9 to 26 mm (mean, 16.6 mm). Pathologic results included subependymal giant cell astrocytomas, ependymomas, nongerminomatous germ cell tumors, and pilocytic astrocytomas. Mean follow-up was 35 months (range, 10-109 months). All patients returned to their neurologic baselines after surgery. Local tumor recurrence occurred in 1 patient and distant recurrence in another. In 1 patient, a transitory intraoperative increase of intracranial pressure without clinical implications occurred. There was no permanent morbidity or mortality in this series. Hydrocephalus was present preoperatively in 5 cases and was treated either with tumor removal alone or with an additional endoscopic third ventriculostomy. No patient required a ventriculoperitoneal shunt.CONCLUSIONS: Neuroendoscopic gross-total resection of solid intraventricular tumors is a safe and efficacious procedure in carefully selected pediatric patients.