The Microsurgical Treatment Of Craniopharyngioma And The Treatment Of Postoperative Complications

Objective: To review and investigate the surgical approach, surgicaltechniques and the postoperative complications of craniopharyngioma, byanalyzing the clinical datas of 38 cases of craniopharyngioma. Methods:Selecting 38 cases of craniopharyngioma which were treated in theNeurosurgery Department in the first hospital of Jilin University, from Jan 2000 toMarch 2006(These cases are all accept the first-time surgery and also confirmedby the pathology after surgery), and then analysing the clinical datas. Resluts: 1. Cystoid tumor: 11cases;parenchymal tumor: 6cases;mixed tumor:21cases. 2. surgical approaches:Pterional approach was performed in 33 cases (86.84%);transfrontalbasalapproach in 2 cases (5.26%);transsphenoidal approach in 2 cases (5.26%);transfrontallobe-lateral ventricle approach in 1 case (2.63%). 3. According to the Hoffman's Grade of the tumor resection:Grade 1: 32 cases (84.21%);Grade 2: 2 cases (5.26%);Grade 3: 4 cases(10.53%). Death: 2 cases (died from the postoperative complications). 4. postoperative complications: Diabetes insipidus 21 cases;hypernatremia 16 cases, 1 case died fromhypernatremia;hyponatremia 6 cases;hyper and hyponatremia 1 case;hypokaliumia 4 cases;hyperpyrexia 11 cases;seizure 4 cases;alimentaryhemorrhage 1 case;vision decreased 1 case;cerebrospinal fluid fistulae 2 cases;unconsciousness 1 case, died 3 days after surgery. Conclusion: 1. Nowdays, the microsurgical treatment of craniopharyngioma has obtainedthe good curative effect.2. Pterional approach is the mainly approach for total removal ofcraniopharyngioma.3. Factors which effect the total removal of craniopharyngioma include:(1) The tumor's size, position and the way it grows.(2) The relationship between the tumor and the hypothalamus.(3) The degree of the tumor's Calcification.(4) The tumor's blood supply and the relationship between the tumor and theimportant vessels.(5) The choice of the surgical approach.(6) The patient who has adrenocortical disfuction does not have the obviouschange after the endocrine treatment should be treated with appeasing surgery orsurgery by stages.(7) The Neurosurgeon's surgical experience, surgical techniques and hisunderstanding to the different surgical approaches.4. The prevention and the treatment of the postoperative complications isnecessary and important for the treatment of craniopharyngioma.