Clinical Analysis Of Resection Of Craniopharyngioma Via Anterior Interhemispheric Approach And Neuroendoscopic Endonasal Approach

Objective This study draws conclusions based on the comparative analysis of two commonly used surgical approaches for craniopharyngioma,and then provides a reference for the selection of reasonable surgical methods for resection of craniopharyngioma.Methods Collected data of 52 adult patients who were treated by neurosurgery in the General Hospital of Ning Xia Medical University from January 2010 to December 2020 and were pathologically confirmed to be craniopharyngiomas,and their gender,age,clinical manifestations,maximum tumor diameter,and pathological type were collected Comparing differences among other data.The pros and cons of the two surgical approaches were compared from the postoperative improvement rate,operative time,intraoperative blood loss,postoperative complications,postoperative hospital stay,recurrence rate,and mortality.Results There was no statistic difference in data comparison between the patients in the anterior interhemispheric microscope group and the endonasal neuroendoscopy group in terms of gender,age composition,clinical manifestations,tumor maximum diameter,and pathological type(P>0.05).The postoperative symptom improvement rate of patients in the anterior interhemispheric microscope group was 83.33%,the recurrence rate was 11.11%,and the mortality rate was 2.78%.The postoperative symptom improvement rate of patients in the endonasal neuroendoscopy group was 87.5%,the recurrence rate was 6.25%,and the mortality rate was 6.25%.There was no statistical difference in the cure rate,recurrence rate,and mortality rate between the two groups.The operation time of the anterior interhemispheric microscope group was 269.60 ± 51.40 min,and the operation time of the endonasal neuroendoscopy group was 215.31±45.04 min.The mean number of operation time between the two groups was statistically significant(P<0.05).Endoscopic surgery of nasal nerve can shorten the operation time.The blood loss during the period of surgery in the anterior interhemispheric microscope group was 189.72±68.10 ml,and the intraoperative blood loss of the transnasal neuroendoscopy group was 130.63±96.71 ml.The difference between the two groups was statistically significant(P<0.05).It can be considered that there is less bleeding in transnasal neuroendoscopic surgery.The postoperative hospitalization time in the anterior interhemispheric microscope group was 26.64 ± 6.9 days,and the postoperative hospitalization time in the transnasal neuroendoscopy group was 18.62 ± 7.03 days.The difference between the two groups was statistically significant(P<0.05).It can be considered that the hospital stay is shorter for transnasal neuroendoscopic surgery.In terms of complications,the incidence of intracranial infection in the anterior interhemispheric microscope group and the transnasal neuroendoscopy group were 11.11% and 25.00%,respectively,and the incidence of diabetes insipidus was 50.00% and 18.75%,respectively.Postoperative cerebral hemorrhage occurred.The rates were 2.78%,0%,the rates of electrolyte disturbance were 44.44%,6.25%,the rates of hypopituitarism were 41.67%,31.25%,and the rates of postoperative blindness were 2.78%,0%.There was no significant difference in the incidence of postoperative intracranial infection,postoperative intracranial hemorrhage,hypopituitarism,and postoperative blindness between the two groups(P=0.231>0.05,P=1>0.05,P=0.476 ﹥ 0.05,P=1>0.05),and the incidence of postoperative diabetes insipidus and electrolyte imbalance were statistically significant(P=0.023<0.05,P=0.007<0.05),we can think of neuroendoscope as transnasal can significantly reduce the incidence of postoperative diabetes insipidus and electrolyte imbalance.Conclusion The anterior interhemispheric approach and the neuroendoscopic transnasal approach for resection of craniopharyngiomas have the same curative effect,but the neuroendoscopic transnasal approach for resection of craniopharyngiomas can shorten the operation time and reduce bleeding volume and shortening the postoperative hospital stay,and reducing the occurrence of postoperative complications should be faster and safer options for recovery.