Prevention and treatment of complications following resection of pineal lesions via modified Poppen approach
10.3760/cma.j.issn.1671-8925.2018.06.014
- VernacularTitle:改良Poppen入路松果体区病变显微切除术的常见并发症及其防治
- Author:
Chuandong CHENG
1
;
Ying JI
;
Chaoshi NIU
;
Shiying LING
;
Xianming FU
;
Yehan WANG
Author Information
1. 230001 合肥,安徽省立医院神经外科,脑功能与脑疾病安徽省重点实验室,安徽省脑立体定向神经外科研究所
- Keywords:
Lesions;
Pineal region;
Poppen approach;
Surgery complications
- From:
Chinese Journal of Neuromedicine
2018;17(6):615-619
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore prevention and treatment of complications following resection of pineal lesions via the modified Poppen approach.Methods From January 2008 to December 2017,62 patients received resection of pineal region lesions via the modified Poppen approach at Department of Neurosurgery,Anhui Provincial Hospital.Their clinical data and outcomes were reviewed.The incidences of postoperative complications were compared between the patients with differences in lesion diameter,tentorial angle and preoperative hydrocephalus.Results Of this cohort,total tumor resection was performed in 48,subtotal resection in 10 and partial resection in 4.Follow-ups from 3 to 12 months revealed 2 cases of hemianopia which were recovered 3 months later,7 cases of occipital lobe contusion,2 cases of monoparesis and 2 cases of intracranial infection.Of the 7 cases of occipital lobe contusion,3 had intracranial hematoma which had been removed by secondary surgery and 4 had ataxia.The incidences of postoperative hemianopia and monoparesis for the patients with a lesion ＞4.5 cm in diameter were significantly higher than for those with a lesion ≤4.5 cm in diameter (P＜0.05).The incidence of postoperative hemianopia for the patients with a tentorial angle ＞60° was significantly higher than for those with a tentorial angle ≤ 60° (P＜0.05).Conclusions Size and tentorial angle of the lesion may be closely associated with the complications following resection of pineal lesions via the modified Poppen approach.The key to reducing the postoperative complications lies in comprehensive preoperative assessments,familiarity with clinical anatomy of the Poppen approach,sophisticated surgical skills and an individualized surgical protocol.
