Surgical Treatment and Clinical Outcomes of Petroclival Meningiomas: A Single-Center Experience of 107 Patients.
Surgical Treatment and Clinical Outcomes of Petroclival Meningiomas: A Single-Center Experience of 107 Patients.
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质脑膜瘤的手术治疗和临床结果：107例患者的单中心体验。
DOI：
10.3389/fonc.2021.761284
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发表时间：
2021
影响因子：
4.7
通讯作者：
Hu S
中科院分区：
文献类型：
--
作者：
Gao B;Zhang Y;Tan J;Ouyang J;Tai B;Cao X;Li T;Hu S
本研究旨在通过回顾不同手术入路治疗经斜坡脑膜瘤（PCMs）的临床结果，确定最佳手术策略。这项回顾性研究从2010年至2020年在作者所在机构入组了107例PCM患者。分析患者人口统计学资料、临床特征、各种手术方法、主要发病率、术后颅神经缺损和肿瘤进展或复发。颞下经天幕入路（STA）17例，川濑入路（KA）22例，乙状窦后入路（RSA）31例，乙状窦前入路（ASA）即岩后入路（PPA）34例。全切除或次全切除96例（89.7%）。脑神经功能损害新发和加重发生率分别为13.1%（14/107）和10.4%（15/144）。术后并发颅内感染14例，脑脊液漏9例，颅内血肿3例（1例二次手术）。术前和术后Karnofsky体能状态（KPS）评分分别为80（范围60-100）和78.6（范围0-100），但无统计学意义（P>0.05）。在平均5.1年（范围0.3- 10.6年）的随访后，23例患者证实肿瘤进展或复发。2例死于术后并发症。对于PCM的治疗，实现全切除仍然是一个挑战。通过精心的手术计划和先进的显微外科技术，大多数PCM患者可以获得满意的肿瘤切除范围和功能保留，尽管在术后早期短暂的神经功能恶化。
This study aimed to establish optimal surgical strategies via reviewing the clinical outcomes of various surgical approaches for the pertroclival meningiomas (PCMs). This retrospective study enrolled 107 patients with PCMs at the authors’ institution from year 2010 to 2020. Patient demographics, the clinical characteristics, various operative approaches, major morbidity, post-operative cranial nerve deficits and tumor progression or recurrence were analyzed. The subtemporal transtentorial approach (STA), the Kawase approach (KA), the retrosigmoid approach (RSA) and the anterior sigmoid approach (ASA), namely the posterior petrosal approach (PPA) were adopted for 17 cases, 22 cases, 31 cases and 34 cases respectively. Total or subtotal resection was achieved in 96 cases (89.7%). The incidence of new-onset and aggravated cranial nerve dysfunction were 13.1% (14/107) and 10.4% (15/144), respectively. Furthermore, 14 cases suffered from intracranial infection, 9 cases had cerebrospinal fluid leakage, and 3 cases sustained intracranial hematoma (1 case underwent second operation). The mean preoperative and postoperative Karnofsky Performance Status (KPS) score was 80 (range 60-100) and 78.6 (range 0-100), but this was not statistically significant (P>0.05). After a mean follow-up of 5.1 years (range 0.3- 10.6 years), tumor progression or recurrence was confirmed in 23 cases. Two cases died from postoperative complications. For the treatment of PCMs, it is still a challenge to achieve total resection. With elaborate surgical plans and advanced microsurgical skills, most patients with PCMs can be rendered tumor resection with satisfactory extent and functional preservation, despite transient neurological deterioration during early postoperative periods.
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影响因子：
2.4
作者：
Li, Peng;Yang, Zhijun;Liu, Pinan
通讯作者：
Liu, Pinan
影响因子：
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作者：
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4.1
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