| Objective:To summarize the experiences of surgical treatment ofcraniopharyngioma and discusses the choice of craniopharyngioma surgicalapproach, intraoperative points as well as the prevention of complicationsafter operation.Maximum removal of the tumor under the premise of Themaximum protection important organizational structure and reduce thepostoperative complications.Methods: We retrospectively analyzed the clinical data of46patientswho took surgical treatment in our hospital from May2008to2008.According to patient’s tumor imaging characteristics we choosedifferent surgical approach to remove the tumor, comparing the treatmenteffect of different surgical approach.Results:In46patients with craniopharyngioma,21cases of male,female25cases.Aged9-68, the average age of43.2plus or minus9yearsold.43cases took surgery for the first time,3cases of recurrence after firstoperation.Starting symptoms mainly for drinking urine (20cases),headache (15cases), decreased vision (12cases), hypogonadism (7cases), fatigue sleepiness (3cases) and retardation (2cases).Among them2casesusing neural endoscopic through the right nostril transsphenoidal approach,6cases using the forehead down to the road,10cases via pterion approach,12cases using the corpus callosum-septum pellucidum-vault into theroad,16cases of the longitudinal crack on premenstrual-end plate into theroad.29patients received total resection,12cases received subtotalresection and5cases mostly resection.Follow-up39patients dischargedfrom hospital, with an average follow-up of28.3months,21cases getnormal life and to participate in the work,9cases with adenohypophysishypofunction require long-term oral hydrocortisone replacement treatment,8cases with intractable urine collapse nedd long-term use of coagulationcontrol, and3cases of postoperative vision loss,1case was hurt by thehypothalamus and adenohypophysis function seriously andf cannot providefor oneself.There were12cases of patients who were not able to cut thetumor totally and recurrence after three years, Five routine gamma knifetreatment,7cases without further treatment.No deaths.Conclusion:1.Microsurgical resection is the first choice for treatmentof craniopharyngioma, total resection for the first time can get the besttreatment effect.2.Craniopharyngiomas close to the third ventricle are mostdifficult to resect, the longitudinal crack on premenstrual-end plate intothe road or by the corpus callosum septum pellucidum-between into thevault has good effect to remove such tumors.3.According to the preoperative imaging characteristics of patients with craniopharyngioma toselect the appropriate surgical approach, intraoperative pay attention toprotect the hypothalamus and pituitary stalk is the key to successfuloperation.4.Closely monitor the patient’s postoperative consciousness, vitalsigns, electrolytes, and the change of the urine output, timely treatment ofcomplications can obtain good therapeutic effect. |
