Clinnical Efficacy Analysis Of Lateral Ventricle Tumors Resected By Transcortical Transventricular Approach

Objective: To analyze the clinical characteristics of lateral ventricle tumors,and to explore the feasibility of lateral ventricle tumors resected by transcortical transventricular approach.Methods:The clinical data of 62 patients with lateral ventricle tumors treated by the same operator from January 2012 to October 2016 were retrospectively analyzed in Department of Neurosurgery,the First Affiliated Hospital of Nanchang University.CT and / or MRI scan were performed before operation.All patients were treated by microsurgical operatiuon.24 tumors located in the frontal horn and body of lateral ventricle were resected by frontal transcortical transventriclular approach;38 tumors located in the triangular area and temporal angle of the lateral ventricle were resected by temporal transcortical transventriclular approach.The extension of tumor resection,complications,improvement of symptoms and postoperative follow-up results were analyzed to evaluate the feasibility of transcortical transventricular approach for resection of tumors in the lateral ventricles.Results: Total tumor resection was achieved in 53 cases,near total resection in9 cases,total resection rate was 85.48%,no operative death.All cases were confirmed by pathological examination,benign tumor in 26 cases,low-grade glioma in 22 cases,high grade glioma in 6 cases,and other malignant tumor in 8 cases.Epidural hematoma occurred during operation in 2 cases,postoperative epidural hematoma in 2 cases,transient aphasia in 1 case,intracranial infection in 5 cases,symptomatic hydrocephalus in 2 cases,transient diplopia in 1 cases,subdural effusion in 1 cases,no paralysis,epilepsy,visual field defect occurred in all patients.Symptoms disappeared or improved in 59 cases(95.16%),and kept no change in the2(3.23%)cases,aggravated in 1 cases(1.61%).Preoperative KPS score were(69.52± 17.50),and postoperative KPS score were(94.84 ± 13.76),difference between preoperative KPS and postoperative KPS was statistically significant.72.58%patients were follow from 3 months to 3 years.Postoperative radiotherapy wasperformed in 13 cases,radiotherapy and chemotherapy in 7 cases,and chemotherapy in 1 cases.Tumor recurred in 8 cases,and 6 cases died of tumor recurrence.Conclusion: Transcortical transventricular approach provided a good view to the tumor and wide operative field,with high rate of total resection,and few complications.Transcortical transventricular approach was an ideal approach for lateral ventricular tumor resection.Superior frontal gyrus transcortical approach was superior to middle frontal gyrus transcortical approach with a low postoperative complication rate of epilepsy,hemiplegia and aphasia.