Analysis Of Related Factors Of Occipital Lobe Injury After Removal Of Pineal Lesions By Poppen Approach

Objective By retrospectively analyzing the clinical data of 50 patients with pineal lesions,the related factors of occipital lobe injury after removal of pineal lesions by Poppen surgical approach were explored,in order to provided a basis for rational selection of surgical approach before operation and timely detection of occipital lobe injury.Methods The clinical data of 50 patients with pineal lesions treated by Poppen surgical approach from the Department of Neurosurgery,First Affiliated Hospital of Zhengzhou University from March 2013 to August 2018 were collected.The gender,age,maximum diameter of the lesion,inclination of the straight sinus,pathological type,lesion texture,hydrocephalus,positional relationship between the straight sinus and the corpus callosum,positional relationship between the lesion and the cap,positional relationship between the lesion and the canopy,resection degree,preoperative and postoperative KPS scores were analyzed by analysis of variance or rank sum test for univariate analysis and multivariate logistic regression analysis to determine the factors associated with postoperative occipital lobe injury.Results Univariate analysis showed blood loss of unit weight(12.4 ± 31.3 ml,p = 0.041),postoperative KPS score(76.4 ± 18.3 points,p = 0.001),positional relationship between lesion and cap(p = 0.006)are related to postoperative pillow Leaf damage.Multivariate logistic regression analysis suggested that the positional relationship between the lesion and the cap(p = 0.029)was an independent risk factor for predicting the degree of postoperative occipital lobe injury.Gender,age,maximum diameter of lesion,sinus tilt,pathological type,lesion texture,presence or absence of hydrocephalus,positional relationship between sinus and corpus callosus,positional relationship between lesion and canopy,degree of resection and preoperative KPS score were no associated with occipital lobe injury(p>0.05).Conclusions1.When the poppen approach is used to remove the lesions in the pineal region,the postoperative KPS score may be related to the degree of postoperative occipital lobe injury.The relationship between the lesion subject and the position of the cap is a risk factor for predicting the degree of postoperative occipital lobe injury.2.Preoperative evaluation of the positional relationship between the lesion and the canopy can predict the degree of postoperative occipital lobe injury.When the Poppen approach is used to remove the lesion before the cap,the incidence of postoperative occipital lobe injury is high,and other methods can be reasonably selected.3.Low postoperative KPS scores suggest that occipital lobe injury may be possible,and timely intervention can improve the prognosis of patients.4.The inclination of the straight sinus,the positional relationship between the straight sinus and the corpus callosum,the positional relationship between the lesion and the canopy,the presence or absence of hydrocephalus,gender,age,maximum diameter of the lesion,degree of resection,and preoperative KPS score were not associated with postoperative occipital lobe injury.