| Background:Craniopharyngiomas are the most common tumors in the sellar region of children.They mostly occur in the saddle or suprasellar.It is a pathologically benign tumor with a poor clinical prognosis.Craniopharyngioma is one of the challenges that neurosurgery often faces.With the development and maturity of neuroendoscopic technology,the nerve injury rate and postoperative complication rate in the surgical treatment of craniopharyngioma have been significantly reduced,and the prognosis of patients has been greatly improved.Purpose:The purpose of this study was to compare two commonly used surgical approaches for craniopharyngioma in clinic,that is,the surgical effect and complication rate of endoscopic transnasal sphenoidal approach and traditional transcranial approach.And then provide reference for decision-making of surgical approach in the clinical treatment of craniopharyngioma.Methods:According to the set inclusion and exclusion criteria,the data of 18 craniopharyngioma patients admitted to the Neurosurgery Department of a hospital from March 2016 to February 2022 were screened,a total of 43 cases.Relevant clinical data of these 43 patients were comprehensively collected,including general basic information,clinical manifestations,imaging examinations,relevant examination results,postoperative imaging examinations,examination results,pathology reports,etc.,and were retrospectively analyzed.Result:After the analysis of the two groups of data,the p values of the two groups of patients in terms of gender composition,age composition,clinical manifestations,tumor size,surgical classification,and pathological classification were all greater than0.05.There was no significant difference in these aspects between the two groups of patients.It is considered that it is feasible to compare the therapeutic effects of the two groups of patients treated with different surgical approaches.The average operation time of patients in the control group was 249.44±56.17 min,and the average operation time of patients in the study group was 193.20±51.60 min,p=0.002<0.05,it is considered that the operation time used in the research group is shorter than that in the control group.The average intraoperative blood loss in the control group was203.89±76.55 m L,and the average intraoperative blood loss in the study group was141.60±83.55 m L,p=0.017<0.05,it is considered that the intraoperative blood loss in the study group is less than that in the control group.In the control group,there were 8cases of total resection and 10 cases of subtotal resection;in the study group,19 cases of total resection and 6 cases of subtotal resection.p=0.035<0.05,it is considered that the degree of tumor resection in the study group is better than that in the control group.The improvement rates of postoperative typical symptoms in the control group and the study group were 77.8% and 88.0%,p= 0.633>0.05,it is considered that there is no significant difference in the improvement of typical symptoms between the two groups of patients.The analysis results of intracranial infection among postoperative complications showed: p=0.380>0.05,and there was no significant difference in the probability of postoperative intracranial infection between the two groups.The analysis result of diabetes insipidus is: p=0.012<0.05;the analysis result of electrolyte disorder is: p=0.015<0.05,it is believed that the incidence of postoperative diabetes insipidus and electrolyte disturbance in the study group was significantly lower than that in the control group.The average postoperative hospital stay of patients in the control group was 19.89±5.12 days;the average postoperative hospital stay of patients in the study group was 15.32±3.58 days,p=0.001<0.05,it is considered that the postoperative hospital stay of the patients in the study group was significantly shorter than that in the control group.During the 1-year follow-up of postoperative patients,the recurrence rates of the control group and the research group were 11.1% and8%,p=1>0.05,there was no significant difference in the recurrence rate between the two groups at 1 year after surgery.During the 1-year follow-up,the mortality rate of patients in the control group was 5.6%;the mortality rate of patients in the study group was 4.0%.p=1>0.05,there was no significant difference in postoperative 1-year mortality between the two groups.Conclusion:1.Neuroendoscopic treatment of primary craniopharyngioma requires shorter operation time and less intraoperative bleeding.2.The total resection rate of neuroendoscopic surgery is higher than that of transcranial approach.3.With neuroendoscopic treatment,the incidence of diabetes insipidus and electrolyte disturbance is low,and cerebrospinal fluid rhinorrhea may occur.4.The hospitalization time of patients treated with neuroendoscopy is shorter. |
PDF Full Text Request