ABSTRACT
Objective:To explore the selection of surgical methods for different sites of symptomatic Rathke's cleft cyst (RCC) and the clinical efficacies of these patients.Methods:Forty-seven patients with symptomatic RCC, admitted to our hospital from January 2016 to December 2019, were chosen in our study; 21 patients with intrasellar symptomatic RCC accepted surgery via unilateral nasal approach at the right side, 19 patients with intra-suprasellar symptomatic RCC accepted surgery via bilateral nasal approach, 3 patients with suprasellar symptomatic RCC accepted endonasal transsphenoidal surgery under endoscope, and 4 patients with suprasellar symptomatic RCC accepted craniotomy via pterion approach. The clinical efficacies and complications of patients accepted different surgical methods were compared. All patients were followed up for 3-36 months to observe the recurrence.Results:The postoperative symptoms of the patients were effectively improved, including headache relief ratio of 27/31, vision loss improvement ratio of 5/5, high prolactin relief ratio of 11/13, pituitary function improvement ratio of 9/18. Complications occurred in 6 patients, presenting as diabetes insipidus. Four patients recurred during follow-up.Conclusion:Intrasellar and intra-suprasellar symptomatic RCC accepted surgery via endoscopic transnasal transsphenoidal approach are safe and effective; selection of surgical methods for suprasellar symptomatic RCC should be determined according to the sizes and growth directions of cysts.
ABSTRACT
Objective To explore the impact of MR imaging T2 fluid-attenuated inversion-recovery sequence (MRI T2Flair) excision extension and postoperative chemotherapy in prognosis of patients with glioblastoma (GBM). Methods A retrospective study of clinical data and treatment efficacy of 17 patients with GBM, admitted to our hospital from April 2012 to August 2016, was performed. All patients were performed tumor resection by using awake anesthesia, neuroimage navigation, and intraoperative direct electrical stimulation. The impacts of the resection extent of T2Flair lesions and adjuvant chemotherapy on the prognosis of glioblastoma were analyzed. Results T1 enhanced lesions in these 17 patients were totally resected. The median follow-up duration was 18 months (8 months to 52 months). Median survival time was 20 months; the survival time of patients with resection ranges of 0%-10%, 10%-25% and more than 25% were 19, 22 and 24 months, respectively, without statistical differences (P>0.05). The patients adopted less than 6 courses chemotherapy had a 19-month-long median survival time, and those adopted 6 courses or more courses chemotherapy had a 33-month-long median survival time, with statistically significant difference (P<0.05). Conclusion When T1 enhanced lesions are totally resected, the resection extent of T2Flair lesions has no influence on patients survival time; however, patients accepted 6 or more courses of chemotherapy have a better survival.