Wang Junlu,Chen Ruoping,Zhang Li.Application value of IPCNM technique during operations for posterior fossa tumors in children[J].Journal of Clinical Pediatric Surgery,,18():1023-1030.[doi:10.3969/j.issn.1671-6353.2019.12.008]
Application value of IPCNM technique during operations for posterior fossa tumors in children
- Keywords:
- Cranial Fossa; Posterior/SU; Neoplasms; Surgical Procedures; Operative; Neuroelectrophysiological monitoring; Child
- CLC:
- R726;R739.41;R741.044
- Abstract:
- Objective To explore the outcomes of neuroelectrophysiological monitoring plus microsurgical resection of pediatric posterior fossa (PF) tumors on the protection of cranial nerve function.Methods From March 2012 to December 2015,42 hospitalized children with PF tumors as confirmed by computed tomography (CT) or magnetic resonance imaging (MRI) were retrospectively recruited as research subjects.Nineteen cases of PF tumor undergoing simple microscopical resection from March 2012 to August 2013 were classified as non-IPCNM group.And another 23 cases of PF tumor undergoing microscopical resection plus multi-mode neuroelectrophysiological monitoring from September 2013 to December 2015 were designated as IPCNM group.The real-time intra-operative status of posterior cranial nerves was observed for IPCNM group to provide appropriate operative assistance and timely guidance.Cranial nerve functions were followed up.And pre-operative and post-operative recovery of cranial nerve function was compared between two groups and within each group.The inter-group difference of total tumor resection rate was also compared.Results Among them,13/23 cases (56.52%) underwent total tumor resection in IPCNM group versus 10/19 (52.63%) in non-IPCNM group.And the difference was not statistically significant (χ2=0.098,P=0.752).Also cranial nerve function of IPCNM group was compared and analyzed between groups and within groups at 1,4,12,24 and 48 weeks post-operation.And the differences were statistically significant (P<0.05).The differences were statistically significant between non-IPCNM and preoperative groups at 1,4 and 12 weeks post-operation (P<0.05).Statistically significant differences existed in cranial nerve functions between IPCNM and non-IPCNM groups at 1 and 4 weeks post-operation (P<0.05).Conclusion Combined multi-mode neuroelectrophysiological monitoring during operation of pediatric PF tumor not only provides rationales for avoiding the injury of posterior cranial nerve,but also effectively reduces the incidence of complications and surgical risks and shorten the recovery time of posterior cranial nerve function.Although combined intraoperative electrophysiological monitoring has facilitated the resection of PF tumor,it has not further improved its total resection rate.
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Memo
收稿日期:2018-09-29。
基金项目:申康医院发展中心，第一轮促进市级医院临床技能与临床创新三年行动计划（编号：16CR3070B）
通讯作者:张立,Email:zhangl1@children.com.cn