脑转移患者的外科治疗和术后结果:我们的外科经验

Adem Doğan, M. Durmaz, İ. Gezgin, A. Kaplan
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摘要

目的:转移性脑肿瘤是成人最常见的颅内病变,也是癌症患者发病和死亡的重要原因。方法:收集131例患者的临床资料,包括年龄、性别、症状、部位、引物部位、手术方式、切除、并发症及复发情况。结果:女性50例(38.1%),男性81例(61.8%)。患者平均年龄54,9岁。最常见的住院原因是头痛(68.7%)。脑半球病变108例(82.4%),后颅窝病变23例(17.5%),多发病变16例(12.2%)。所有患者(n=131)均行神经导航手术。全切除25例(19%),全切除83例(63.3%),次全切除18例(13.7%),活检5例(3.8%)。根据组织病理学检查,最常见的肿瘤起源于肺部(n= 63,48%)。随访期间平均总生存期为5.3个月(1-36个月)。12例(9.1%)患者复发并再次手术。结论:多学科综合治疗是治疗转移性脑肿瘤的有效方法。有效的手术干预消除肿瘤周围水肿和颅内压升高可提高术后生存率。此外,术后全脑放疗可减少复发,提高生存率。
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Surgical Management and Postoperative Outcome in patients with Brain Metastases: Our Surgical Experience
Aims: Metastatic brain tumors are the most commonly seen intracranial lesion in adults and an important cause of morbidity and mortality in patients with cancer. This study aimed to evaluate the postoperative mortality, morbidity, and survival rates of patients who underwent surgery in our clinic for metastatic brain tumorsMethod: Clinical data of 131 patients, including age, sex, symptoms, localization, primer site, surgical methods, resection, complications and recurrence were collected.Results: Fifty patients (38.1%) were female, and 81 (61.8%) patients were male. The average age of the patients was 54,9. The most common reason for hospital admission was headache (68.7%). Lesions were detected in the cerebral hemisphere in 108 (82.4%) patients and the posterior fossa in 23 (17.5%) patients, and 16 (12.2%) patients had multiple lesions. All patients (n=131) underwent surgery with neuronavigation. Total resection was performed in 25 (19%) patients, gross total resection in 83 (63.3%), subtotal resection in 18 (13.7%), and biopsy in 5 (3.8%). The most commonly seen tumor originated from the lungs (n=63, 48%), according to the histopathological examination. The mean overall survival was 5.3 (range, 1–36) months during the follow-up period. Twelve (9.1%) patients had recurrence and underwent surgery again.Conclusion: Multidisciplinary treatment methods are used in the treatment of metastatic brain tumors. Effective surgical intervention to eliminate peritumoral edema and increased intracranial pressure improves postoperative survival rates. In addition, post-surgical whole-brain radiotherapy reduces recurrence and improves survival.
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