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目的 研究第四脑室 小脑脚 脑干区肿瘤的形态学特点 ,以及安全地切除此部位肿瘤的手术方法。方法 儿童 (15岁以下 )第四脑室 小脑脚 脑干区肿瘤 (室管膜瘤和星形细胞瘤 ) 2 3例 ,术前头颅MRI证实瘤体起源于小脑脚或侧隐窝 ,分别向第四脑室、脑干、CPA和斜坡生长。采用枕下正中外侧拐入路 ,术中分区域切除肿瘤。结果 全切除肿瘤 12例 ,近全切除 9例 ,大部切除 2例。无手术死亡。术后病理证实室管膜瘤 13例 ,恶性室管膜瘤 2例 ,星形细胞瘤 8例。结论 起源于小脑脚或侧隐窝的肿瘤 ,以脑干为中心呈半弧形生长 ,肿瘤侵袭范围包括第四脑室、小脑脚、脑干、CPA和斜坡。合适的手术入路和术中分区域切除肿瘤的技术 ,可以做到安全地全切除和 /或近全切除肿瘤。
Objective To study the morphological characteristics of the fourth ventricle in the brain stem region of the brain stem and to safely remove the tumor in this region. Methods Twenty-three cases of brain (ependymoma and astrocytoma) in the fourth ventricle of the cerebellum of the fourth ventricle in children (under 15 years old) were confirmed by preoperative cranial MRI. The tumors originated in the cerebellar peduncle or lateral recess, Four ventricle, brainstem, CPA and slope growth. Subaxillary midline lateral approach, intraoperative sub-regional excision of the tumor. Results Total resection of the tumor in 12 cases, nearly total resection in 9 cases, mostly in 2 cases. No surgery died. Postoperative pathology confirmed 13 cases of ependymoma, 2 cases of malignant ependymoma, 8 cases of astrocytoma. Conclusions The tumors originating from the cerebellar peduncle or lateral recess grow semi-arcuately with the brainstem as the center. The tumor invasion includes the fourth ventricle, cerebellum, brainstem, CPA and slope. Appropriate surgical approaches and intra-operative sub-regional tumor removal techniques allow for safe total and / or near-total tumor removal.