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目的探讨经胼胝体-透明隔-穹窿间入路显微手术方法切除第三脑室和松果体区肿瘤并行终板造瘘术的疗效,讨论显微解剖学的理论基础。方法对经胼胝体-透明隔-穹窿间入路显微手术切除第三脑室和松果体区肿瘤并行终板造瘘术29例患者的临床资料进行回顾分析。结果 29例在手术显微镜下行肿瘤全切除13例,次全切除7例,部分切除9例。均在处理完肿瘤后行终板造瘘术。结论经胼胝体-透明隔-穹窿间入路手术切除第三脑室和松果体区肿瘤系通过胚胎组织残留的透明隔间隙进入第三脑室,正常组织损伤极少,可在直视操作下切除第三脑室及松果体区肿瘤,肿瘤全切除或次全切除率高,对于未做肿瘤全切除及考虑术后局部组织肿胀或放疗期间局部肿胀致导水管开口梗阻者,可同时行终板造瘘术,以解决脑积水问题。
Objective To investigate the curative effect of endoscopic ostomy in the third ventricle and the pineal region by microsurgical treatment of the corpus callosum - transseptal - vault approach, and to discuss the theoretical basis of microscopic anatomy. Methods The clinical data of 29 patients who undergone endoscopic ostomy in the third ventricle and the pineal region by microsurgical removal of the corpus callosum - translucent and invaginal approach were retrospectively analyzed. Results Twenty-nine patients underwent total resection of the tumor under the operating microscope in 13 cases, subtotal resection in 7 cases and partial resection in 9 cases. After the treatment of tumor endplate ostomy. CONCLUSIONS: The tumors in the third ventricle and the pineal region underwent surgical resection through the corpus callosum - transseptal - fornix approach into the third ventricle through the clear compartment of the embryo. The lesions in the normal tissue are rare, and can be excised under direct vision operation Third ventricle and pineal region tumors, total tumor resection or subtotal resection rate is high, for not complete tumor resection and consider the local tissue swelling after surgery or local swelling during the opening of the aqueduct obstruction, at the same time end plate can be made Fistula surgery to solve the problem of hydrocephalus.