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Retrospective Analysis of Craniopharyngiomas Treated by Microsurgery

Author: WangXiaoFei
Tutor: LiGang
School: Shandong University
Course: Surgery
Keywords: Craniopharyngioma Microsurgery Surgical approach
CLC: R739.4
Type: Master's thesis
Year: 2009
Downloads: 39
Quote: 0
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Abstract


Objective: To investigate the clinical effect of microsurgical resection of craniopharyngioma, approach and press surgery were divided into three groups, a comparative study. Methods: A retrospective analysis carried out in our hospital from April 2005 to December 2008, 66 cases of microsurgical resection of craniopharyngioma, depending on the surgical approach is divided into three groups: the pterional 26 cases; diastema - endplate approach in 23 cases; frontalis - interhemispheric approach in 17 cases. Microsurgical treatment of clinical effect analysis from the five aspects of the incidence of clinical manifestations, imaging features, the choice of the surgical approach, the degree of tumor resection and postoperative complications. And the difference between the three different surgical approach group were statistically analyzed. Results: 1, three different surgical approach to patients with gender, age, preoperative symptoms and tumor maximum diameter of the differences were not statistically significant. 2,66 surgeries were successful, with no deaths. (60.6%) of 40 tumors total resection, subtotal resection in 16 cases (24.2%), subtotal resection in 10 patients (15.2%). Which pterional Road 26 cases in 16 cases (61.5%) of total resection; diastema - endplate into the road subtotal resection in 23 cases, 15 cases (65.2%); frontalis - interhemispheric approach in 17 cases, 9 cases (52.9 %) wholly resection. Three different surgical approach group, no significant difference in the rate of tumor removal. 3,58 cases (87.9%) patients after varying degrees of diabetes insipidus or preoperative symptoms get worse. 48 cases (72.7%) patients with postoperative electrolyte imbalance. Which, by the the pterional group of postoperative occurrence of diabetes insipidus or preoperative symptoms add to the 23 cases, 19 cases of electrolyte imbalance occurs; endplate postoperative symptoms of diabetes insipidus or preoperative approach group diastema - increase of 20 cases electrolyte imbalance occurs 16 cases; diabetes insipidus or preoperative symptoms get worse in 15 cases by the amount of the end - after interhemispheric approach, electrolyte imbalance occurs in 13 cases. Compare three different surgical approach to group the incidence of postoperative diabetes insipidus and electrolyte imbalance, the difference was not statistically significant. Conclusion: 1, microsurgical resection of craniopharyngioma is an effective method for the treatment of craniopharyngioma. Preoperative comprehensive analysis of the imaging data, the to select minimal surgical injury and maximize revealed tumor surgical approach can be satisfactory resection. 2, craniopharyngioma postoperative complications, the high incidence. Diabetes insipidus and electrolyte disorders are the most common postoperative complications, but it can be controlled more after active treatment. Postoperative positive prevention and treatment of complications to ensure the effects of the surgery, and improve patients' quality of life after the key. 3 wing point, interhemispheric - endplate frontalis - the diastema three different surgical approach was no significant effect of tumor resection, the difference in the incidence of postoperative complications.

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