与外细胞瘤中手术后的脊髓液泄漏相关的危险因素
Huan Zhang1, Sophie Peeters2, Gennadiy Vengorivich1
1Department of Head and Neck Surgery, UCLA David Geffen School of Medicine, Los Angeles, California, United States.
Journal of neurological surgery. Part B, Skull base
|January 26, 2024
概括
细胞外瘤,特别是断层瘤,在内镜手术后显示出更高的术后脑脊液 (CSF) 泄漏率. 预防性腰部排水可能有利于高风险患者.
科学领域:
- 神经外科 神经外科
- 在瘤学瘤学.
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
背景情况:
- 手术后的脑脊液 (CSF) 泄漏是脑瘤手术的已知并发症.
- 虽然对垂体瘤进行了广泛的研究,但对于细胞外瘤的CSF泄漏率的数据并不常见.
研究的目的:
- 为了调查与术后CSF泄漏相关的风险因素,在接受细胞外瘤内镜切除的患者中.
- 为了比较不同瘤位置和手术因素之间的CSF泄漏率.
主要方法:
- 对100名接受了细胞外瘤内切除的患者 (2008-2020年) 的回顾性图表审查.
- 分析患者的人口统计,瘤特征 (类型,位置,大小),手术重建技术和并发症.
- 统计分析,以确定手术后脑脊髓泄漏的重大风险因素.
主要成果:
- 17%的患者出现了手术后的CSF泄漏,中位数发生在手术后2天.
- 与其他瘤部位相比,临床瘤的术后CSF泄漏发生率显著更高 (p < 0.05).
- 根据BMI,瘤大小,重建方法或并发症,没有观察到泄漏率的显著差异.
结论:
- 细胞外瘤,特别是位于关节的瘤,具有比 pituitary 瘤更高的 postoperative CSF 泄漏风险.
- 这些发现表明,预防性腰部排水可能是高风险患者的宝贵考虑因素.
- 进一步的研究可能会阐明影响漏洞发展的特定手术内因素.
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