Retrospective analysis operation treatment of 26 cases of craniopharyngioma / 中国综合临床

ABSTRACT

Objective To analyze operation resection of craniopharyngioma operation experience,and to evaluation of therapeutic effect of operation.Methods Clinical data of 26 cases patient of craniopharyngioma treated by craniotomy from July 2008 to July 2013 in the Department of Neurosurgery of the People's Hospital of Xinjiang Uygur Autonomous Region for microsurgical operation resection were retrospectively analyzed.The main clinical manifestations, imaging features, the selection of operation treatment and operation approach, extent ofsection of tumor after operation, the occurrence of complications and follow up outcome were analyzed.Results Six cases with brain frontal botton+longitudinal fissure+brain endplate approach,4 cases with brain frontal botton approach, 5 cases with cerebral longitudinal fissure + callosum approach, 11 cases with pterion approach.Total removal was achieved in 19 cases, subtotal resection in 6 cases, most resection in 1 cases.Bilateral olfactory nerve in 22 cases of complete retention, unilateral olfactory nerve stretch mutilation in 4 cases,20 cases of pituitary stalk were identified, and 1 cases of anterior communicans anterior rupture give electrocoagulation cut.Enamel cell type in 23 cases, squamous epithehal cells type 3 cases.Postoperative diabetes insipidus 18 cases, electrolyte disturbances 16 cases, pituitary function decline 5 cases, secondary brain edema 2 cases, 1 case of postoperative epilepsy, 1 cases of death.The pursuit of total was diabetes insipidus factors(x2 =4.807, P =0.046), 5 cases of recurrence, 3 cases go again operztion treatment, 2 cases for the gamma knife treatment, the tumor recurrence rate of total removal lower subtotal resection and most resection (Z =-3.718 P=0.000).The tumor recurrence rate of puget tumor grade level 2 higher than puget tumor grade level 0 and puget tumor grade level 1 (Z =-3.124 P =0.000).The quality of life score (KPS) more than 70 points in 15 cases,60-70 points in 8 cases, ≤60 points in 2 cases.Conclusion Craniopharyngioma preferred operation treatment.Evaluation of preoperative imaging and operation approach is the key to successful operation.The correct operation of the surgery and treatment strategies, advantageous to resection tumor, effective prevention of postoperative complications.Postoperative residual tumor is the main cause of recurrence of craniopharyngioma.Recurrence of craniopharyngioma treatment should individualized therapy after weigh the advantages and disadvantages.