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首页> 外文期刊>Neurosurgery >Complete microsurgical resection of colloid cysts with a dual-port endoscopic technique.
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Complete microsurgical resection of colloid cysts with a dual-port endoscopic technique.

机译：使用双端口内窥镜技术完成胶体囊肿的完整显微手术切除。

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OBJECTIVE: A dual-port endoscopic approach, used for the surgical management of colloid cysts, was developed with the following goals: 1) a direct, unobstructed, high-illumination endoscopic view of the attachment point of the colloid cyst to the tela choroidea, and 2) a gross total resection of the colloid cyst capsule using microsurgical techniques. METHODS: Eleven symptomatic, hydrocephalic, colloid cyst patients who underwent operation with a unilateral, precoronal-frontopolar dual-port endoscopic technique were retrospectively assessed. Preoperative magnetic resonance imaging scans were analyzed, comparing the lateral precoronal to the frontopolar approach, to determine the degree of angulation that would be required to directly view the roof of the third ventricle. Clinical outcome and radiographical follow-up were assessed. RESULTS: The frontopolar approach achieved an approach angle to the roof of the third ventricle of only 15 +/- 4 degrees compared with 56 +/- 6 degrees (P < 0.0001) for the precoronal approach. The view obtained from the frontopolar endoscope allowed excellent visualization of the cyst attachment point. Microsurgical dissection techniques, using many standard microsurgical instruments introduced through the second port, were satisfactorily accomplished. Complete resections were obtained in 10 out of 11 dual-port patients. Worsening of memory deficits occurred in one patient. There was no cyst recurrence with a mean follow-up period of 26 +/- 27 months. CONCLUSION: The dual-port endoscopic technique described is an alternative to classic microsurgical craniotomy approaches. The technique allows excellent visualization of the colloid cyst attachment and permits microdissection techniques.
机译：目的：开发了一种用于胶体囊肿手术治疗的双端口内窥镜检查方法，其目标如下：1）胶体囊肿与胸膜脉络膜附着点的直接，无障碍，高照明的内窥镜观察， 2）使用显微外科技术对胶体囊肿囊进行总切除。方法：回顾性评估11例有症状，脑积水，胶体囊肿的患者，这些患者接受了单侧冠状动脉前额极双端口内窥镜手术。术前进行了磁共振成像扫描，比较了前冠状动脉外侧入路和额极入路，以确定直接观察第三脑室顶部所需的成角度程度。评估临床结果和影像学随访。结果：前极入路到第三脑室顶的进角仅为15 +/- 4度，而冠状动脉前入路的进角为56 +/- 6度（P <0.0001）。从额极内窥镜获得的视野可以很好地观察到囊肿的附着点。使用通过第二端口引入的许多标准显微外科手术器械，显微外科解剖技术得到了令人满意的实现。 11位双端口患者中有10位获得了完整切除。一名患者发生记忆缺陷恶化。没有囊肿复发，平均随访期为26 +/- 27个月。结论：所描述的双端口内窥镜技术是经典显微外科开颅手术的替代方法。该技术可实现胶体囊肿附着的出色可视化，并可进行显微解剖技术。

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