| Ting Lei,Baofeng Wang,Juan Chen,Yu Xu,Kai Shu,Wei Sun,Shaozheng Liu,Xiaopeng Li. Transsphenoidal microsurgical treatment of infradiaphragmatic craniopharyngioma. Oncol Transl Med, 2016, 2: 197-202. |
| Transsphenoidal microsurgical treatment of infradiaphragmatic craniopharyngioma |
| Received:July 08, 2016 Revised:October 17, 2016 |
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| KeyWord:craniopharyngioma; transsphenoidal approach; therapeutic effect |
| Author Name | Affiliation | Department | | Ting Lei | Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | Department of Neurosurgery | | Baofeng Wang | Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China | Department of Neurosurgery | | Juan Chen | Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China | Department of Neurosurgery | | Yu Xu | Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China | Department of Neurosurgery | | Kai Shu | Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China | Department of Neurosurgery | | Wei Sun | Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China | Department of Neurosurgery | | Shaozheng Liu | Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China | Department of Neurosurgery | | Xiaopeng Li | Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China | Department of Neurosurgery |
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| Abstract: |
| Objective Typically, the transcranial approach has been used for the treatment of craniopharyngiomas
with suprasellar extension, whereas the transsphenoidal approach has been used mostly for infradiaphragmatic craniopharyngioma. Total resection of craniopharyngioma can reduce the recurrence rate, especially
in young children, but it may lead to severe complications. Therefore, any benefit of the degree of resection must be weighed against the risk of complications by the surgeons. The purpose of this study was
to explore the therapeutic outcome after transsphenoidal microsurgical treatment of infradiaphragmatic
craniopharyngioma and share our experiences.
Methods Between January 2003 and June 2013, 30 patients with infradiaphragmatic craniopharyngioma
underwent transsphenoidal microsurgical resection in our hospital. The neurological, visual, and endocrine
functions, and extent of resection were analyzed retrospectively. Recurrence or growth of residual tumor
tissue during follow-up was assessed using magnetic resonance imaging (MRI).
Results Total resection was achieved in 25 patients (83.3%), subtotal resection was achieved in 4 patients (13.3%), and partial resection was achieved in 1 patient (3.4%). There were no perioperative deaths.
Cerebrospinal fluid (CSF) leakage occurred in 6 patients, and among them, 2 required surgical repair of the
sella. New-onset postoperative diabetes insipidus (DI) developed in 8 patients. Vision and visual fields were
improved at different levels in 13 out of 16 patients who had sight impediments before treatment. Tumor
recurrence and regrowth was observed in 2 patients; 1 patient underwent transsphenoidal reoperation,
the condition of the other patient who had undergone several craniotomies grew worse over the 6-month
follow-up period.
Conclusion Transsphenoidal surgery is an ideal choice in treating infradiaphragmatic craniopharyngioma. The transsphenoidal approach, which preserves pituitary function and avoids damage to the hypothalamic structures and optic nerve, is associated with fewer complications than the transcranial approach and
a low mortality rate. |
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