Analysis And Comparison Of The Modified Poppen Approach For Microsurgical Removal Of Adult Pineal Region Tumors

Objective:To explore the therapeutic effect of the modified Poppen approach for microsurgical removal of adult pineal region tumors and to determine a safer and more effective surgical approach by comparing the advantages and disadvantages of other approaches for surgery.Methods:The clinical data of adult patients with pineal tumors who received surgical resection from August 2013 to October 2018 were collected from the Department of Neurosurgery,The affiliated Provincial Hospital of Anhui Medical University.The clinical data of the above patients were followed up.The clinical data and follow-up of the above patients were retrospectively analyzed.Results:The clinical data of 49 eligible patients were collected,including 29 patients underwent the modified Poppen approach,19 patients underwent the Krause approach,and 1 patient underwent the lateral ventricle approach(due to limited data availability,the lateral ventricle approach case was excluded in the study).For patients who underwent the modified Poppen approach,the Barthel index score was performed 1month after surgery.The score is significantly higher than the preoperative score,the difference was statistically significant(83.8±17.1,95.2±10.8,P<0.001).There were no statistically significant differences in preoperative general information of patients in the modified Poppen approach and the Krause approach group such as gender(male15/29,female 14/29;male 9/19,female 10/19,P>0.05),age(47.0 ± 14.8 y,50.9 ±12.1y,P>0.05).No significant statistical difference was found in the comparison of tumor maximum diameter(3.11±0.51 cm,2.99±0.58cm).In the comparison of the two groups,there was no statistically significant difference on the rate of total resection(24/29,82.8%;13/19,68.4%,P>0.05)and the remission rate of hydrocephalus(11/17,64.7%;9/11,81.8%,P>0.05).However,the intraoperative blood loss(358.8±54.8ml,407.6±79.7ml,P>0.05)and the length of hospitalization after surgery(13.2±3.6d,15.9±4.5d,P>0.05)in the two groups were statistically significant.No significant differences were found in the analysis of early postoperative complications.Conclusion:For adult patients with pineal tumors,microsurgical resection of brain tumors via the modified Poppen approach can significantly improve the Barthel index score,indicateing a significant improvement in patients’ daily living abilities.In the two groups of patients who underwent surgery via the modified Poppen approach and the Krause approach,there was no significant difference in the tumor resection and remission of hydrocephalus.But the average value of amount of intraoperative blood loss and the length of hospitalization after surgery in the modified Poppen approach group was less than that in the Krause group,which reflects the superiority of the modified Poppen approach.