INC德國Schroeder教授：成人后顱窩腫瘤手術(shù)前后腦積水的發(fā)生率及治療-INC國際神經(jīng)外科醫(yī)生集團(tuán)

　　Abstract

　　Background:There is paucity of information about the frequency of hydrocephalus prior to and after posterior fossa tumor surgery in adult patients and about the best way it should be managed.The present study was conducted to determine the frequency of hydrocephalus prior to and after posterior fossa tumor surgery in adult patients as well as the value of an endoscopic third ventriculostomy(ETV)prior to posterior fossa tumor surgery with regard to the rate of perioperative complications and persistent hydrocephalus.

　　Methods:A single-institution retrospective chart review of all posterior fossa tumor surgeries of our department in a 10-year period(2005 to 2014)has been done.

　　Results:Fifty-two of 243 adult patients with posterior fossa tumors presented with hydrocephalus at the time of admission prior to tumor surgery.39/52 received early tumor surgery,11/52 an ETV prior to tumor surgery and in 2/52 an external ventricular drainage(EVD)was inserted prior to tumor surgery.3/52 patients required a permanent cerebrospinal fluid(CSF)diverting procedure for persistent hydrocephalus after tumor removal.One hundred ninety-one patients did not demonstrate a hydrocephalus before surgical treatment and four of them developed a post-resection hydrocephalus.

　　Conclusion:The frequency of hydrocephalus prior to posterior fossa tumor surgery in adult patients is 21.4%and therefore much lower than in respective reports of pediatric patients.The risk of persistent hydrocephalus and newly developed hydrocephalus after tumor surgery was very low,too(5.7 and 2.1%,respectively).An ETV is not justified in every adult patient prior to posterior fossa tumor surgery.

顱窩腫瘤

　　背景：關(guān)于成人后顱窩腫瘤手術(shù)前后腦積水的發(fā)生率以及治療的較佳方法的信息很少。本研究旨在確定成人后顱窩腫瘤手術(shù)前后腦積水的發(fā)生率，以及后顱窩腫瘤手術(shù)前內(nèi)鏡三腦室造口術(shù)（ETV）對圍手術(shù)期并發(fā)癥和持續(xù)性腦積水發(fā)生率的價(jià)值。

　　方法：對我科2005～2014年10年間全部后顱窩腫瘤手術(shù)進(jìn)行單機(jī)構(gòu)回顧性分析。

　　結(jié)果：243例成人后顱窩腫瘤患者中，52例在腫瘤手術(shù)前入院時(shí)出現(xiàn)腦積水。39/52接受早期腫瘤手術(shù)，11/52在腫瘤手術(shù)前使用ETV，2/52在腫瘤手術(shù)前插入體外心室引流（EVD）。3/52例腫瘤切除術(shù)后持續(xù)性腦積水需行長期性腦脊液（CSF）分流術(shù)。191例患者在手術(shù)治療前沒有表現(xiàn)出腦積水，其中4例在手術(shù)后出現(xiàn)腦積水。

顱窩腫瘤

　　結(jié)論：成人后顱窩腫瘤手術(shù)前腦積水發(fā)生率為21.4%，明顯低于相應(yīng)的兒童病例報(bào)告。腫瘤術(shù)后持續(xù)性腦積水和新發(fā)腦積水的風(fēng)險(xiǎn)也很低（分別為5.7%和2.1%）。在后顱窩腫瘤手術(shù)前，并非每個(gè)成年患者都能接受ETV治療。

　　關(guān)于德國Henry W.S.Schroeder教授

　　以神經(jīng)內(nèi)鏡技術(shù)處理垂體瘤、顱咽管瘤、部分腦膜瘤等神經(jīng)外科疾病，具有創(chuàng)傷小、順利度高、等優(yōu)點(diǎn)，很多只需要經(jīng)鼻蝶入路操作即可，不用經(jīng)過腦內(nèi)，對額顳葉的腦組織也不會出現(xiàn)損傷。而在國際范圍內(nèi)，INC國際神經(jīng)外科醫(yī)生集團(tuán)旗下國際神經(jīng)外科顧問團(tuán)的德國Henry W.S.Schroeder教授正是尤擅神經(jīng)內(nèi)鏡準(zhǔn)確順利切除的國際教授專家之一。

　　Henry W.S.Schroeder教授作為德國以及國際神經(jīng)內(nèi)鏡專家，在國際神經(jīng)外科學(xué)界享有盛名。他經(jīng)常作為特邀講師指導(dǎo)國內(nèi)神經(jīng)外科專家開展垂體瘤、腦膜瘤等神經(jīng)內(nèi)鏡手術(shù)技術(shù)培訓(xùn)，普及神經(jīng)內(nèi)鏡手術(shù)在國內(nèi)的應(yīng)用，與國內(nèi)神經(jīng)外科專家共同交流進(jìn)步。Schroeder教授還和德國其他教授一起合著、編纂了《神經(jīng)內(nèi)鏡手術(shù)》一書。在神經(jīng)內(nèi)鏡設(shè)備領(lǐng)域出名的小兒神經(jīng)內(nèi)鏡Lotta內(nèi)鏡就是Schroeder教授在2004年發(fā)明并用自己的女兒Lotta名字命名的。

　　原文鏈接：https://www.sci-hub.pl/10.1016/j.neuroscience.2020.06.035