欢迎来到抗癌健康网!  
放入收藏夹 | pc蛋蛋助赢软件

pc蛋蛋答题器:新手术法可摘除脑部深处肿瘤

pc蛋蛋助赢软件 www.ez4a.com.cn 2018-06-21

抗癌健康网

手机看网页

导读:即使是有经验的脑神经外科医生对于这一肿瘤也有很多顾虑,为了规避风险,往往不敢全部摘除,导致脑正中部分经?;岵辛糁琢?,残存的部分要进行放疗。

  颅咽管瘤是一种发生于脑内深部的常见先天性pc蛋蛋助赢软件。虽然它是良性pc蛋蛋助赢软件,但是如果体积达到一定程度,就会导致失明和认知能力降低。日本大阪市立大学的研究小组开发出了一种新手术方法,通过切开耳后的骨骼来摘除颅咽管瘤,成功地将10年后的复发率控制在15%以下。

  日本全国每年约有700人患颅咽管瘤,以前,一般都是切开眼球中间或者是额角骨骼以摘除肿瘤,但是由于颅咽管瘤会围绕视神经和脑深部的重要血管发育,如果在手术过程中伤害了视神经和颈内动脉,就会导致出现视力低下、失明、血管破裂等严重的并发症,所以是脑肿瘤中最难以摘除的一种。

  即使是有经验的脑神经外科医生对于这一肿瘤也有很多顾虑,为了规避风险,往往不敢全部摘除,导致脑正中部分经?;岵辛糁琢?,残存的部分要进行放疗。但由于视神经对放射线非常脆弱,所以放射线剂量不能太大,也导致复发率非常高。

  为此,大阪市立大学开发出了切开耳后的岩骨部分,从视神经和动脉后方取出肿瘤的方法。此手术方法与以前手术方法不同,是从后下方达到肿瘤部位,能够最大限度地露出肿瘤,可以在不损伤视神经和颈内动脉等重要部位的情况下摘除肿瘤。

  自1999年以来,研究小组对16名颅咽管瘤患者进行了手术,其中15人的肿瘤几乎全被摘除,并发症的发病率也非常低,10年间的无复发率达到86.5%。

  研究小组带头人、大阪市立大学教授大畑建治说:“希望将其作为安全且复发率低的手术方法加以普及,以帮助更多患者。”

  这一成果的论文已经刊登在新一期的《神经外科学杂志》网络版上。

  Journal of Neurosurgery DOI: 10.3171/2013.10.JNS13673

  Surgical outcomes of the minimum anterior and posterior combined transpetrosal approach for resection of retrochiasmatic craniopharyngiomas with complicated conditions

  Noritsugu Kunihiro, M.D., Takeo Goto, M.D., Kenichi Ishibashi, M.D., and Kenji Ohata, M.D.

  OBJECT

  Retrochiasmatic craniopharyngiomas are surgically challenging tumors. Retrochiasmatic craniopharyngiomas with complicated conditions such as large diameter, major calcification, or significant extension to the third ventricle or posterior fossa present surgical challenges; moreover, recurrent retrochiasmatic craniopharyngiomas are particularly formidable challenges. Although the transpetrosal approach to retrochiasmatic craniopharyngiomas published by Hakuba in 1985 can provide unique advantageous exposure of the retrochiasmatic area to allow safe neurovascular dissection and facilitate radical tumor removal, the procedure is viewed as complicated and time consuming and has a high risk of damaging hearing functions. The authors have modified Hakuba's technique to minimize petrosectomy and reduce surgical complications and have applied this modified approach to retrochiasmatic craniopharyngiomas with complicated conditions. In this study, the authors describe their technique and surgical outcomes to elucidate the role of this modified transpetrosal approach for retrochiasmatic craniopharyngiomas with complicated conditions. This is the first study to report surgical outcomes of the transpetrosal approach for retrochiasmatic craniopharyngiomas.

  METHODS

  Between 1999 and 2011, the minimum anterior and posterior combined (MAPC) transpetrosal approach, which is a modification of Hakuba's transpetrosal approach, was applied in 16 cases of retrochiasmatic craniopharyngiomas with complicated conditions. Eight cases were recurrent tumors, 4 had previously received radiotherapy, 11 had a large diameter, 10 had large calcification, 15 had superior extension of the tumor into the third ventricle, and 10 had a posterior extension of the tumor that compressed the midbrain and pons. In all 16 patients, more than 2 of these complicated conditions were present. The follow-up duration ranged from 0.8 to 12.5 years (mean 5.3 years). Surgical outcomes assessed were the extent of resection, surgical complications, visual function, endocrinological status, and neuropsychological function. Five-year and 10-year recurrence-free survival rates were also calculated.

  RESULTS

  Gross-total or near-total resection was achieved in 15 cases (93.8%). Facial nerve function was completely maintained in all 16 patients. Serviceable hearing was preserved in 15 cases (93.8%). Visual function improved in 13 out of 14 cases (92.9%) that had visual disturbance before surgery. None of the patients experienced deterioration of their visual function. Twelve cases had endocrinological deficit and received hormonal replacement before surgery. New endocrinological deficit occurred in 2 cases (12.5%). Neuropsychological function was maintained in 14 cases (87.5%) and improved in 1 case (6.3%). One case that had received previous conventional radiotherapy treatment showed a gradual decline in neuropsychological function. The 5-year and 10-year recurrence-free survival rates were both 86.5%.

  CONCLUSIONS

  The authors obtained good results by using the MAPC transpetrosal approach for the removal of retrochiasmatic craniopharyngiomas with complicated conditions. The MAPC transpetrosal approach should be considered as a therapeutic option for selected cases of retrochiasmatic craniopharyngiomas with complicated conditions.

在这里,掌握健康资讯

扫描左侧二维码即可添加抗癌健康网官方微信;
健康之路 与你同行
卵巢癌更多>>
热文欣赏更多>>

健康阅读

推荐欣赏

  • 热门推荐
  • 最新期刊
  • 疾病关注
长期憋尿,膀胱癌,长期憋尿引发膀胱癌
[详情]
白血病与骨髓移植术
[详情]
筷子致癌?靠什么吃饭?
[详情]
卵巢囊肿并不可怕
[详情]
调理内分泌多吃黄色食物
[详情]
吃腐乳致癌可信吗?
[详情]
资讯排行榜更多>>
肺癌康复指南吃什么?
信息聚焦更多>>
化疗药物中成药止痛药
奥沙利铂参丹散结胶囊阿司匹林
紫杉醇臌症丸扑热息痛
卡铂贞芪扶正颗粒盐酸哌替啶片
泰素阿魏化痞膏吗啡
氟尿嘧啶软膏西黄丸芬太尼
视频推荐更多>>
肿瘤热文欣赏更多>>

特别声明:本站信息仅供参考 不能作为诊断及医疗的依据平台联系我们

抗癌健康网 版权所有 未经授权请勿转载  CopyRight?2008-2018 pc蛋蛋助赢软件 www.ez4a.com.cn, All Rights Reserved. 浙ICP备11014848号