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目的探讨按肿瘤起源决定侧脑室内肿瘤手术入路的经验。方法回顾性分析自2002年1月至2009年1月在我院接受手术治疗的29例侧脑室内肿瘤患者的临床资料。其中15例采用经皮层入路,14例采用经纵裂入路。结果 23例肿瘤全切除,6例次全切除。病理证实良性肿瘤14例,低级别胶质瘤8例,高级别胶质瘤5例,恶性肿瘤2例。经皮层入路组患者术后癫痫发病率明显高于经纵裂入路组。平均随访时间为18.5个月,58.62%恢复良好。结论经纵裂胼胝体入路是治疗侧脑室内肿瘤较理想的手术入路,但对于肿瘤较大或肿瘤向脑实质延伸者或继发性脑室内肿瘤经皮层入路是较好的选择。肿瘤应争取全切,但不可强求全切,残留部分可进行放疗和(或)化疗。
Objective To explore the experience of surgical approaches to determine lateral ventricle tumors by tumor origin. Methods The clinical data of 29 patients with intracerebral ventricular tumors who underwent surgery in our hospital from January 2002 to January 2009 were retrospectively analyzed. Among them, 15 cases were treated by transcortical approach and 14 cases were treated by longitudinal incision. Results 23 cases of total tumor resection, subtotal resection in 6 cases. Pathologically confirmed in 14 cases of benign tumors, low grade glioma in 8 cases, 5 cases of high grade glioma, 2 cases of malignant tumors. The incidence of postoperative epilepsy in patients who underwent transcortical approach was significantly higher than that in patients who underwent longitudinal incision. The average follow-up time was 18.5 months and 58.62% recovered well. Conclusion Longitudinal approach of the corpus callosum is an ideal surgical approach for the treatment of lateral ventricle tumors. However, it is a better choice for the treatment of large tumors or the extension of tumors to the brain parenchyma or secondary intraventricular tumors. Tumor should strive for full cut, but not forced to cut, the remaining part of the radiotherapy and (or) chemotherapy.