Torkildsen分流术在合并脑积水的松果体区肿瘤手术中的应用

打开文本图片集

【中图分类号】R739.41;R651 【文献标志码】A 【文章编号】1672-7770（2025）05-0526-07

Application Torkildsen shunt in the surgery for pineal region tumors complicated with hydrocephalus WANG Binbin，CHEN Chengzhi，JI Jing，LIU Ning，YOU Yongping，ZHANG Liying，ZHAO Lin.

Corresponding author： ZHAO Lin

Abstract： Objective To explore the prognostic factors in pineal region tumors（PRT） and provide evidence for the improvement therapeutic strategy. MethodsA retrospective cohort study 24 PRT patients was performed in the Afiliated University from January 2O13 through December 2O24.Demographic and clinical variables were evaluated. Prognostic factors were analyzed in statistical analysis.ResultsThis study consisted 24 PRT patients. The average maximum diameter the tumor was 30.2mm . Hydrocephalus was found in 22（91. 7% ）cases at diagnosis. Twenty （83.3% ）patients underwent tumor resection，among which，gross total resection（GTR）was achieved in 13 cases （65.0%） ，subtotal resection in 3 cases （15.0% ），partial resection in 4 cases （20.0% ）. The GTR rate by endoscopic method was 100% ， which seems higher than 61.1% by open surgery，however the difference was not significant（ P= 0.27）． Among the 22 patients who had hydrocephalus before the surgery，4 .（23.5% ）underwent Torkildsen shunt，in whom GTR wasachieved all（ 100% ）cases，higher than 58.3% in the 12 patients who did not undergo hydrocephalus relieving surgery （ P=0 . 12）．Hydrocephalus was relieved in all 4 patients （ 100% ）who underwent Torkildsen shunt，which was higher than the

60.0% （6/10） in patients with untreated hydrocephalus （ P=0 .13）．Average operation time in those who underwent Torkildsen shunt was 4.58 hours， shorter than 5.34 hours in the 12 patients without shunt（ P=0.54 ）.ConclusionsIn PRT patients，Torkildsen shunt might be valuable to provide better surgical field exposure，increase GTR rate，improve hydrocephalus relief and shorten operation time.

Key words：pineal region tumor；obstructive hydrocephalus；torkildsen shunt

松果体区肿瘤（pinealregiontumors，PRTs）是起源于松果体及其周围结构的罕见肿瘤[1]，占中枢神经系统（centralnervoussystem，CNS）肿瘤总数不足1% ，其组织学类型具有高度异质性，主要包括三大类：松果体实质细胞瘤（pinealparenchymaltumors，PPT）、生殖细胞肿瘤（germcelltumors，GCT）以及毗邻结构起源的肿瘤。（剩余10042字）