Microsurgical resection of craniopharyngioma of the third ventricle via an improved transventricular approach.
BACKGROUND
Craniopharyngioma of the third ventricle is difficult to treat and its therapeutic regimens and operative approaches have been controversial. This study was undertaken to probe indications for microsurgical resection of craniopharyngioma of the third ventricle via an improved transventricular approach, its surgical procedures and therapeutic effects, and prevention of postoperative complications.


METHODS
Fifty-one patients with craniopharyngioma of the third ventricle were treated from January 2000 to October 2004 by an improved transventricular approach for removing the tumor via the interventricular foramen, the intermedius of the septum pellucidum or choroid fissure. Symptoms and signs of the patients, and results of imaging, operation, and follow-up were analyzed.


RESULTS
Of the 51 patients who had received the improved transventricular resection, 4 underwent a combined approach with an entrance of the pterion. Forty patients (78.43%) underwent total resection and others subtotal resection, without an operative death. Epileptic seizures were found in 3 patients (5.88%) and subdural effusion in the operative field in 4 (7.84%). All patients showed good general conditions after operation, and follow-up for an average of 27.52 months showed relapse of the tumour in 8 patients (15.69%).


CONCLUSIONS
Microsurgical resection of craniopharyngioma of the third ventricle by an improved transventricular approach has advantages of operative safety and efficacy, lower mortality and disability, and less complications.
Department of Neurosurgery, Huaxi Hospital, Sichuan University, Chengdu 610044, China.
Jian-guo
JG
Xu
Chao
C
You
Bo-wen
BW
Cai
Shu
S
Jiang
Hong
H
Sun
Fu-you
FY
Guo
Yong-bo
YB
Yang
Bo
B
Wu
D000293:Adolescent; D000328:Adult; D000368:Aged; D002551:Cerebral Ventricle Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D003397:Craniopharyngioma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D020542:Third Ventricle