文章：

内窥镜辅助显微手术经微骨窗入路切除颅底脑膜瘤：前颅底与后颅窝在根治程度及预后方面是否存在差异？

Endoscopic-Assisted Microsurgical Meningioma Resection in the Skull Base via Minicraniotomy: Is There a Difference in Radicality and Outcome between Anterior Skull Base and Posterior Fossa?

原文发布日期：31 March 2024

DOI: 10.3390/cancers16071391

类型: Article

开放获取: 是

英文摘要：

Background: Keyhole-based approaches are being explored for skull base tumor surgery; aiming for reduced complications while maintaining resection success rates. This study evaluates skull base meningiomas resected using an endoscopic-assisted microsurgical keyhole approach, comparing outcomes with standard procedures.Methods: Between 2013 and 2019; 71 out of 89 patients were treated using an endoscopic-assisted microsurgical procedure. A total of 42 meningiomas were localized at the anterior skull base and 29 in the posterior fossa. The surgical techniques and use of an endoscope were analyzed and compared in terms of complications, surgical radicality, outcome, and recurrences in the patients’ follow-up.Results: The two different cohorts yielded similar rates of GTR (anterior skull base: 80% versus posterior fossa: 82%). The complication rate was 31% for the posterior fossa and 16% for the anterior skull base. An endoscope was used in 79% of all cases. Tumor remnants were detected by means of endoscopic visualization in 58.6% of posterior fossa and 33% of anterior skull base meningiomas. The statistical analysis revealed significantly higher benefits from endoscope use in the posterior fossa cohort (p< 0.05).Conclusions: The results revealed that endoscopy was beneficial in both locations. The identification of remnant tumor tissue and the benefit of endoscopy were clearly higher in the posterior fossa. Endoscopic assistance is a very helpful tool for increasing radicality, providing a better anatomical overview during surgery, and better identifying remnant tumor tissue in skull base meningioma surgery.

摘要翻译： 

背景：目前颅底肿瘤手术正探索采用锁孔入路，旨在降低并发症发生率的同时维持肿瘤切除成功率。本研究评估了内镜辅助显微外科锁孔入路切除颅底脑膜瘤的疗效，并与标准手术方式进行对比。 方法：2013年至2019年间，89例患者中有71例接受内镜辅助显微外科手术治疗，其中42例脑膜瘤位于前颅底，29例位于后颅窝。研究通过随访数据分析比较了手术技术、内镜使用情况，以及并发症发生率、手术根治程度、预后和复发情况。 结果：两组患者实现肿瘤全切除的比例相近（前颅底：80% vs 后颅窝：82%）。后颅窝手术并发症发生率为31%，前颅底为16%。79%的病例术中使用了内镜，其中后颅窝脑膜瘤术中发现肿瘤残余的比例为58.6%，前颅底为33%。统计分析显示后颅窝手术中内镜使用的获益显著更高（p<0.05）。 结论：研究结果表明内镜技术在两个解剖区域均有应用价值，但在后颅窝手术中对残留肿瘤组织的识别优势更为显著。内镜辅助能有效提升手术根治性，提供更清晰的手术解剖视野，并更好地识别残留肿瘤组织，是颅底脑膜瘤手术中极具价值的辅助工具。

原文链接：

Endoscopic-Assisted Microsurgical Meningioma Resection in the Skull Base via Minicraniotomy: Is There a Difference in Radicality and Outcome between Anterior Skull Base and Posterior Fossa?