显微外科术配合伽玛刀治疗矢状窦旁脑膜瘤的疗效及术后复发情况分析

doi:10.3969/j.issn.1671-7171.2018.03.024

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Abstract 【Objective】To study effects of microneurosurgical techniques combined with gamma knives on parasagittal meningioma and analyze the postoperative recurrent rate.【Methods】A total of 50 patients with parasagittal meningioma treated in our hospital from April 2012 to April 2015 were selected as study subjects. With regards to tumor location, there were 15 cases in the anterior third, 22 cases in middle third and 13 cases in posterior third of the sagittal sinus. Retrospective analysis was conducted on all clinical data. Microneurosurgical techniques were employed as the main treatment, and gamma knife was adopted to handle tumor remnants after surgery. Tumor resection status (classified as benign or malignant through pathological examination) were recorded for all patients.Patients were surveyed for incidence and recurrence rates of various complications through 2 years of follow-ups. KPS scores of quality of life were compared before and after treatment.【Results】According to the Simpson resection classification criteria, there were 16 cases of grade Ⅰ (32%), 8 cases of grade Ⅱ (30%) and 15 cases of grade Ⅲ. The total resection rate of tumors was 78%. There were 11 cases (22.00%) of Simpson grade Ⅳ with a subtotal resection rate of 22.00%. The gamma knife treatment was performed on the Simpson grade Ⅱ, Ⅲ, and Ⅳ resections. After 2 years of follow-up, the clinical symptoms nearly disappeared, and there were no cases of death. Postoperative tumor recurrence occurred in 4 patients (8.00%), including 1 case in both grade Ⅱ and grade Ⅲ and 2 cases in grade Ⅳ. Based on pathological diagnosis, there were 44 benign tumors (88.00%) and 6 malignant tumors (12.00%). The KPS scores before operation was 72.67±3.32 points, which was lower than that of KPS scores after operation of 86.43±4.02 points; the difference was statistically significant (P<0.05). A total of 18 cases (36.00%) had postoperative complications: 9 cases (18.00%) of neurological impairment, 3 cases (6.00%) of spasms, 4 (8.00%) of hematoma, and 2 cases (4.00%) of brain swelling.【Conclusion】Microneurosurgical treatment of sagittal sinus paraneoplastic meningioma has great clinical effects. After resection of residual tumors by gamma knife treatment, it can effectively control the recurrence of tumors. Microneurosurgical techniques combined with gamma knives can significantly improve the quality of life of patients and is worthy of clinical application.

Key words： Microsurgery Meningioma/SU Meningioma/RT Superior Sagittal Sinus Gamma Rays/TU Radiosurgery Recurrence

Received: 13 April 2017

PACS:

R739.45

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http://www.jcr.net.cn/EN/10.3969/j.issn.1671-7171.2018.03.024 OR http://www.jcr.net.cn/EN/Y2018/V35/I3/495

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