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首页> 外文期刊>British journal of neurosurgery >Brainstem gliomas: Surgical indications and technical considerations in a series of 58 cases
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Brainstem gliomas: Surgical indications and technical considerations in a series of 58 cases

机译：脑干神经胶质瘤：58例手术指征和技术考虑

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Objectives. To analyze the indications of surgical treatment, surgical management strategies and post-surgical outcome in patients with brainstem glioma (BSG). Methods. In this retrospective study conducted from 1998 to 2012, 58 patients of surgically treated intrinsic BSG, meeting the inclusion criterion were enrolled. There were 40 males and 18 females, with age range varying from 3 to 55 years. The most common presentation was gait disturbances, either due to cerebellar involvement or motor weakness, followed by motor weakness, ocular involvement and headache. The posteriorly located tumors were operated by midline suboccipital approach (42 patients) and supracerebellar-infratentorial approach (4 patients). Posterolaterally located tumors were operated by retromastoid (10 patients) and all the ventrolateral tumors by subtemporal approach (4 patients). Results. Above 90% patients improved in their neurological status, while 5% deteriorated. Pilocytic astrocytoma was the most common histopathology (41.4%), followed by Grade II astrocytoma (34.5%) and Grade III astrocytoma (24.1%). Overall, 19% patients had postoperative complications and three patients (5%) died in the perioperative period. Conclusions. Surgery is advocated for patients with well delineated, posteriorly, posterolaterally and ventrolaterally located tumors having slow progression and relative preservation of motor power. BSG can have excellent surgical results with surgeon's experience and modern surgical facilities.
机译：目标。分析脑干神经胶质瘤（BSG）患者的手术治疗，手术管理策略和手术后结局。方法。在1998年至2012年进行的这项回顾性研究中，纳入了58例符合入选标准的经手术治疗的固有BSG患者。男40例，女18例，年龄在3至55岁之间。最常见的表现是步态障碍，可能是由于小脑受累或运动无力，然后是运动无力，眼部受累和头痛。后部肿瘤通过中线枕下入路（42例）和小脑腓肠下肌入路（4例）进行手术。位于后外侧的肿瘤由后乳突入路（10例）手术，所有腹侧肿瘤均由颞下入路（4例）进行手术。结果。超过90％的患者神经系统状况得到改善，而5％的患者恶化。上皮型星形细胞瘤是最常见的组织病理学（41.4％），其次是II级星形细胞瘤（34.5％）和III级星形细胞瘤（24.1％）。总体而言，有19％的患者术后出现并发症，三名患者（5％）在围手术期死亡。结论提倡手术治疗的患者，其肿瘤的轮廓，后方，后外侧和腹侧位置良好，进展缓慢且相对保留了动力。 BSG可以凭借外科医生的经验和现代化的手术设备获得出色的手术效果。

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