Microsurgical resection of craniopharyngioma of the third ventricle via an improved transventricular approach

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Author:
XU Jian-guo()
YOU Chao()
CAI Bo-wen()
JIANG Shu()
SUN Hong()
GUO Fu-you()
YANG Yong-bo()
WU Bo()
Journal Title:
CHINESE MEDICAL JOURNAL
Issue:
Volume 118, Issue 10, 2005
DOI:
Key Word:
craniopharyngioma;transventricular approach;therapeutic effect

Abstract: Background Craniopharyngioma of the third ventricle is difficult to treat and its therapeutic regimens and operative approaches have been controversial. This study was undertaken to probe indications for microsurgical resection of craniopharyngioma of the third ventricle via an improved transventricular approach, its surgical procedures and therapeutic effects, and prevention of postoperative complications.Methods Fifty-one patients with craniopharyngioma of the third ventricle were treated from January 2000 to October 2004 by an improved transventricular approach for removing the tumor via the interventricular foramen,the intermedius of the septum pellucidum or choroid fissure. Symptoms and signs of the patients, and results of imaging, operation, and follow-up were analyzed. Results Of the 51 patients who had received the improved transventricular resection, 4 underwent a combined approach with an entrance of the pterion. Forty patients (78.43%) underwent total resection and others subtotal resection, without an operative death. Epileptic seizures were found in 3 patients (5.88%) and subdural effusion in the operative field in 4 (7.84%). All patients showed good general conditions after operation, and follow-up for an average of 27.52 months showed relapse of the tumour in 8 patients (15.69%).Conclusions Microsurgical resection of craniopharyngioma of the third ventricle by an improved transventricular approach has advantages of operative safety and efficacy, lower mortality and disability, and less complications.

  • [1]Sweet WH. Craniopharyngiomas: a summary of data. In: Schmidek HH, ed. Operative neurosurgical techniques. 4th ed. London: Elsevier Science; 2002:477-486.
  • [2]Rickert CH, Paulus W. Lack of chromosomal imbalance in adamantinomatous and papillary craniophryngioma. J Neurol Neurosurg Psychiat 2003;74:260-261.
  • [3]Rienstein S, Adams EF, Pilzer D, et al. Comparative genomic hybridization analysis of craniophryngioma. J Neurosurg 2003;98:162-164.
  • [4]Van Effenterre R, Boch AL. Craniopharyngioma in adults and children: a study of 122 surgical cases. J Neurol 2002;97:3-11.
  • [5]Li SQ. Craniopharyngioma. In: Xu QW, Jiang LP, eds, Clinical craniocerebral diseases. Tianjin: Tianjin Scientific and Technologic Publishing House 2003;278-283.
  • [6]Sekine S, Shibata T, Kokubu A, et al. Craniopharyngiomas of adamantinomatous Type harbor β-catenin gene mutations. Am J Pathol 2002;161:1997-2001.
  • [7]Sami AJ, Sami A. Surgical management of craniopharyngiomas. In: Schmidek HH, ed. Operative neurosurgical techniques. 4th ed. London: Elsevier Science; 2002:489-502.
  • [8]Yasargil MG, Curcic M, Kis M, et al. Total removal of craniopharyngiomas: approaches and long-term results in 144 patients. J Neurosurg 1990;73:3-11.
  • [9]Zhang YQ, Wang ZC, Ma ZY. Craniopharyngioma in children: a clinical analysis of 189 cases. Chin Med J 2000;80:280-282.
  • [10]Lu J, Zhu XL. Advance of the typing and microsurgery for craniopharyngioma. Chin J Neurosurg 2002;7:255-258.
  • [11]Lefranc F, Chevalier C, Vinchon M, et al. Characterization of the levels of expression of retinoic acid receptors, galectin-3,macrophage migration inhibiting factor, and P53 in 51 adamantinomatous craniophryngioma. J Neurosurg 2003;98:145-153.
  • [12]Fuentes S, Metellus P, Dufour H, et al. Postoperative intracranial seeding of craniopharygioma. Three case reports and a review of the literature. Neuro Chirurg 2002;48:345-350.
  • [13]Nelson GA, Bastian FO, Schlitt M, et al. Malignant transformation in craniopharyngioma. Neurosurgery 1988;22:427-429.
  • [14]Johnson, Baehring RR, et al. Surgery for third ventricular tumors. Neurosurg Quarterly 2003;13:207-225.
  • [15]Desai KI, Nadkarni TD, Muzumdar DP, et al. Surgical management of lesion of the third ventricle: a study of 105 cases. Surg Neurol 2002;57:295-304.
  • [16]Shirane R, Su CC, Kusaka Y, et al. Surgical outcomes in 31 patients with craniopharygiomas extending outside the suprasellar cistern:an evaluation of the frontobasal interhemispheric approach. J Neurosurg 2002;96:704-712.
  • [17]Tannka Y, Sugita K, Kobayashi S, et al. Subdural fluid collections following transcortical approach to intra- or paraventricular tumors. Acta Neurochir (Wien) 1989;99:20-25.
  • [18]Pereira P, Cerrjo A, Cruz J, et al. Intracranial aneurysm and vasculopathy after surgery and radiation therapy for craniopharyngioma: case report. Neurosurg 2000;50:885-888.
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