Wu Shuihua,Chen Zhaohui,Fan Shuangshi,et al.Application of interventional embolization plus craniotomy for children with giant hypervascular intracranial tumors[J].Journal of Clinical Pediatric Surgery,,22():356-360.[doi:10.3760/cma.j.cn101785-202211050-011]
Application of interventional embolization plus craniotomy for children with giant hypervascular intracranial tumors
- Keywords:
- Minimally Invasive Surgical Procedures; Endovascular Procedures; Neurosurgical Procedures; Brain Neoplasms; Vascular Neoplasms; Child
- Abstract:
- Objective To explore the application value of endovascular embolization plus microneurosurgery for vascular rich tumors in children.Methods From July 2019 to July 2021,five children with giant intracranial vascular tumor undergoing combined surgery were recruited as research objects.And perioperative complications and outcomes were reviewed retrospectively.Results Among them,there were atypical teratoma/rhabdomyoma (AT/RT) in posterior fossa (WHO Grade Ⅳ,n=2),hairy cell astrocytoma in posterior fossa (WHO Grade Ⅰ,n=1),giant cell astrocytoma (WHO Grade Ⅰ) under ependymal membrane of temporal lobe (WHO Grade Ⅰ,n=1) and polymorphic yellow astrocytoma (WHO Grade Ⅱ,n=1).All patients underwent compound surgery.All of them remained conscious post-operation.Four of them could move their limbs and intracranial hemorrhage was absent on postoperative computed tomography (CT).During a follow-up period of 3 months,magnetic resonance imaging (MRI) reexamination showed no tumor recurrence or progression.Conclusion During microsurgery,preoperative occlusion of major tumor blood supply vessels may significantly minimize hemorrhage and maintain a distinct surgical field.And embolic material has the intraoperative function of positioning and navigation so that it ensures a complete resection of huge vascular rich tumors for retaining normal brain tissue as much as possible and protecting brain function.Compound surgery has an important application value for nervous system tumors.
References:
[1] 马廉亭.什么是"复合手术"及临床应用[J].中国临床神经外科杂志,2022,27(5):428.DOI:10.13798/j.issn.1009-153X.2022.05.036. Ma LT.What is "composite surgery" and its clinical application[J].Chin J Clin Neurosurg,2022,27(5):428.DOI:10.13798/j.issn.1009-153X.2022.05.036.
[2] 戴嵬,孙园园,王娟,等.复合手术在脊髓血管病治疗中的应用[J].中国脑血管病杂志,2021,18(10):704-712.DOI:10.3969/j.issn.1672-5921.2021.10.007. Dai W,Sun YY,Wang J,et al.Application of hybrid operation for spinal cord vascular diseases[J].Chin J Cerebrovasc Dis,2021,18(10):704-712.DOI:10.3969/j.issn.1672-5921.2021.10.007.
[3] 马亮,毕立杰,李伟旺.缺血性脑血管病脑血管造影及介入治疗术后并发症发生情况[J].临床医学研究与实践,2019,4(36):79-80.DOI:10.19347/j.cnki.2096-1413.201936030. Ma L,Bi LJ,Li WW.Complications of cerebral angiography and interventional therapy for ischemic cerebrovascular diseases[J].Clin Res Pract,2019,4(36):79-80.DOI:10.19347/j.cnki.2096-1413.201936030.
[4] 赵岩,韩玉庆,杨新宇,等.应用复合手术室治疗颅内动脉瘤76例分析[J].中华神经外科杂志,2015,31(1):7-10.DOI:10.3760/cma.j.issn.1001-2346.2015.01.002. Zhao Y,Han YQ,Yang XY,et al.Application of hybrid operation room for treatment of intracranial aneurysms:analysis of 76 cases[J].Chinese Journal of Neurosurgery,2015,31(1):7-10.DOI:10.3760/cma.j.issn.1001-2346.2015.01.002.
[5] 周盛轩,谭显西,诸葛启钏.颅内富血管肿瘤栓塞治疗的研究进展[J].国际神经病学神经外科学杂志,2005,32(5):434-438.DOI:10.3969/j.issn.1673-2642.2005.05.014. Zhou SX,Tan XX,Zhuge QC.Research advances in the embolization of intracranial vascular tumors[J].J Int Neurol Neurosurg,2005,32(5):434-438.DOI:10.3969/j.issn.1673-2642.2005.05.014.
[6] Abecassis IJ,Nerva JD,Feroze A,et al.Multimodality management of Spetzler-Martin grade 3 brain arteriovenous malformations with subgroup analysis[J].World Neurosurg,2017,102:263-274.DOI:10.1016/j.wneu.2017.03.046.
[7] Nerva JD,Mantovani A,Barber J,et al.Treatment outcomes of unruptured arteriovenous malformations with a subgroup analysis of ARUBA (a randomized trial of unruptured brain arteriovenous malformations)-eligible patients[J].Neurosurgery,2015,76(5):563-570.DOI:10.1227/NEU.0000000000000663.
[8] 吴水华,陈朝晖,范双石,等.显微手术治疗2月龄婴儿颅内巨大动脉瘤1例并文献复习[J].临床小儿外科杂志,2020,19(6):523-527.DOI:10.3969/j.issn.1671-6353.2020.06.012. Wu SH,Chen ZH,Fan SS,et al.Microsurgery of infantile intracranial aneurysm in a 2-month-old child with a literature review[J].J Clin Ped Sur,2020,19(6):523-527.DOI:10.3969/j.issn.1671-6353.2020.06.012.
[9] Wang C,Zhang JT,Liu A,et al.Surgical management of medullary hemangioblastoma:report of 47 cases[J].Surg Neurol,2001,56(4):218-226.DOI:10.1016/S0090-3019(01)00590-0.
[10] Boutakioute B,Zouine Y,Chehboun A,et al.Successful preoperative embolization of a cystic-solid variant of cerebellopontine angle hemangioblastoma[J].Radiol Case Rep,2022,17(12):4799-4803.DOI:10.1016/j.radcr.2022.09.045.
[11] Ma DX,Wang Y,Du GH,et al.Neurosurgical management of brainstem hemangioblastomas:a single-institution experience with 116 patients[J].World Neurosurg,2015,84(4):1030-1038.DOI:10.1016/j.wneu.2015.05.030.
[12] Muraszko KM,Antunes JL,Hilal SK,et al.Hemangiopericytomas of the spine[J].Neurosurgery,1982,10(4):473-479.DOI:10.1227/00006123-198204000-00010.
Memo
收稿日期:2022-11-25。
基金项目:湖南省科技重大专项(2019SK1010)
通讯作者:沈沉浮,Email:scf680524@csu.edu.cn