细胞内甲状腺分离体作为手术内脑脊髓液泄漏的危险因素,在接受内镜转形手术的患者中
Sauradeep Sarkar1,2, C Eduardo Corrales3, Edward R Laws1
1Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston , Massachusetts , USA.
Operative neurosurgery (Hagerstown, Md.)
|February 8, 2024
概括
在手术前的成像检测中发现的细胞内甲状腺分离体,在垂体瘤手术期间显著增加了手术内脑脊液 (CSF) 泄漏的风险. 外科医生应该考虑为患有这些分泌管的患者量身定制的手术方法.
科学领域:
- 神经外科 神经外科
- 神经辐射学神经辐射学
- 内分泌学 在内分泌学.
背景情况:
- 细胞内状分离器经常在内镜透形外科手术前的术前成像中观察到.
- 鉴别这些分流器对于手术规划和风险评估至关重要.
研究的目的:
- 在一个庞大的脑垂体瘤患者队列中,以质量和数量来表征细胞内甲状腺分离体.
- 为了评估细胞内样分离体和手术内脑脊液 (CSF) 泄漏之间的关联.
主要方法:
- 对530名接受 pituitary 瘤内透切除的患者进行手术前成像的分析.
- 匹配的队列分析比较了具有显著 (>50%的细胞深度) 转管的患者和没有转管的患者.
- 分离体的形态分类为1型 (腹腔CSF裂) 和2型 (中央CSF裂).
主要成果:
- 在40.2%的病例中存在甲状腺分泌体;在12.5%的病例中存在显著分泌体.
- 显著的分离器与手术内脑脊髓泄漏有很强的关联 (P < .001).
- 后勤回归确定了显著的分离器存在作为手术内CSF泄漏的独立预测因子 (OR 4.545).
结论:
- 细胞内甲状腺分离体的存在表明,在下垂体瘤的跨形手术期间,手术内CSF泄漏的风险较高.
- 外科医生应根据这些患者细胞病理的程度考虑量身定制的,有限的外科暴露.
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