Microsurgical management of pineal region lesions: personal
experience with 119 patients

J 2008

Microsurgical management of pineal region lesions: personal experience with 119 patients

HERNESNIEMI, Juha; R. ROMANI; BS. ALBAYRAK; H. LEHTO; R. DASHTI et al.

Základní údaje

Originální název

Microsurgical management of pineal region lesions: personal experience with 119 patients

Název česky

Mikrochurgický management lézí pineální oblasti - osobní zkušenosti u 119 pacientů.

Autoři

HERNESNIEMI, Juha; R. ROMANI; BS. ALBAYRAK; H. LEHTO; R. DASHTI; C. 3rd RAMSEY; A. KARATAS; A. CARDIA; Ondřej NAVRÁTIL; A. PIIPPO; M. FUJIKI; S. TONINELLI a M. NIEMELÄ

Vydání

Surgical Neurology, 2008, 0090-3019

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30000 3. Medical and Health Sciences

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Impakt faktor

Impact factor: 1.556

Označené pro přenos do RIV

Ano

Kód RIV

RIV/00216224:14110/08:00051118

Organizační jednotka

Lékařská fakulta

DOI

https://doi.org/10.1016/j.surneu.2008.07.019

UT WoS

000261701000004

Klíčová slova anglicky

Infratentorial supracerebellar approach; Occipital interhemispheric approach; Pineal region lesions; Hydrocephalus; Follow-up

Štítky

follow-up, hydrocephalus, Infratentorial supracerebellar approach, Occipital interhemispheric approach, Pineal region lesions

Příznaky

Mezinárodní význam

Změněno: 10. 4. 2012 14:14, Mgr. Michal Petr

Anotace

ORIG CZ

V originále

Lesions of the pineal region are histopathologically heterogeneous but often accompanied with severe progression of clinical signs. Surgical treatment remains challenging because of the close vicinity of the deep venous system and the mesencephalo-diencephalic structures in this region. We present the surgical approaches and techniques in a consecutive series of 119 patients treated by the senior author (J.H.) between 1980 and 2007 at 2 different neurosurgical university centers in Kuopio and Helsinki, Finland. Methods: Of the included patients, 107 (90%) presented with pineal region tumors and 12 (10%) with vascular malformations. The ITSC route was used for removal of the lesion in 111 (93%) patients and the OIH approach in 8 (7%) patients. All except one patient were operated on in a sitting position. Results: We reviewed all clinical data and radiographic images and analyzed all surgical videos. The pineal lesions were removed completely in most cases (88%). There was no Surgical mortality. Twenty-two (18%) of the patients had complications in the postoperative period; these included 1 epidural hematoma, 9 transient Parinaud syndrome, 2 meningitis, 3 wound infections, 2 transient memory disturbances, 2 mild hemiparesis, 1 CSF fistula, and 2 cranial nerves palsies (Wand VI). During a 3.5-year follow-up, 12 patients with malignant lesions died; all patients with benign tumors survived. Conclusions: The ITSC route is a safe and effective surgical approach, associated with low morbidity, complete lesion removal, and definitive histopathologic diagnosis. Considering risk vs benefit, we therefore believe that the surgical treatment can be offered in most cases as the first treatment option for pineal tumors.

Česky

V článku prezentujeme naše zkušenosti s mikrochirurgickou operativou pineálních lézí u 119 pacientů, z nichž většina byla operována infratentoriálním supracerebellárním přístupem, který je bezpečným přístupem k těmto afekcím. Speciální pozornost je věnována mirochirurgické technice.

Citovat

HERNESNIEMI, Juha; R. ROMANI; BS. ALBAYRAK; H. LEHTO; R. DASHTI; C. 3rd RAMSEY; A. KARATAS; A. CARDIA; Ondřej NAVRÁTIL; A. PIIPPO; M. FUJIKI; S. TONINELLI a M. NIEMELÄ. Microsurgical management of pineal region lesions: personal experience with 119 patients. Surgical Neurology. 2008, roč. 70, č. 6, s. 576-583. ISSN 0090-3019. Dostupné z: https://doi.org/10.1016/j.surneu.2008.07.019.

@article{818570,
   author = {Hernesniemi, Juha and Romani, R. and Albayrak, BS. and Lehto, H. and Dashti, R. and Ramsey, C. 3rd and Karatas, A. and Cardia, A. and Navrátil, Ondřej and Piippo, A. and Fujiki, M. and Toninelli, S. and Niemelä, M.},
   article_number = {6},
   doi = {https://doi.org/10.1016/j.surneu.2008.07.019},
   keywords = {Infratentorial supracerebellar approach; Occipital interhemispheric approach; Pineal region lesions; Hydrocephalus; Follow-up},
   language = {eng},
   issn = {0090-3019},
   journal = {Surgical Neurology},
   title = {Microsurgical management of pineal region lesions: personal experience with 119 patients},
   volume = {70},
   year = {2008}
}

TY  - JOUR
ID  - 818570
AU  - Hernesniemi, Juha - Romani, R. - Albayrak, BS. - Lehto, H. - Dashti, R. - Ramsey, C. 3rd - Karatas, A. - Cardia, A. - Navrátil, Ondřej - Piippo, A. - Fujiki, M. - Toninelli, S. - Niemelä, M.
PY  - 2008
TI  - Microsurgical management of pineal region lesions: personal experience with 119 patients
JF  - Surgical Neurology
VL  - 70
IS  - 6
SP  - 576-583
EP  - 576-583
SN  - 00903019
KW  - Infratentorial supracerebellar approach
KW  - Occipital interhemispheric approach
KW  - Pineal region lesions
KW  - Hydrocephalus
KW  - Follow-up
N2  - Lesions of the pineal region are histopathologically heterogeneous but often accompanied with severe progression of clinical signs. Surgical treatment remains challenging because of the close vicinity of the deep venous system and the mesencephalo-diencephalic structures in this region. We present the surgical approaches and techniques in a consecutive series of 119 patients treated by the senior author (J.H.) between 1980 and 2007 at 2 different neurosurgical university centers in Kuopio and Helsinki, Finland. Methods: Of the included patients, 107 (90%) presented with pineal region tumors and 12 (10%) with vascular malformations. The ITSC route was used for removal of the lesion in 111 (93%) patients and the OIH approach in 8 (7%) patients. All except one patient were operated on in a sitting position. Results: We reviewed all clinical data and radiographic images and analyzed all surgical videos. The pineal lesions were removed completely in most cases (88%). There was no Surgical mortality. Twenty-two (18%) of the patients had complications in the postoperative period; these included 1 epidural hematoma, 9 transient Parinaud syndrome, 2 meningitis, 3 wound infections, 2 transient memory disturbances, 2 mild hemiparesis, 1 CSF fistula, and 2 cranial nerves palsies (Wand VI). During a 3.5-year follow-up, 12 patients with malignant lesions died; all patients with benign tumors survived. Conclusions: The ITSC route is a safe and effective surgical approach, associated with low morbidity, complete lesion removal, and definitive histopathologic diagnosis. Considering risk vs benefit, we therefore believe that the surgical treatment can be offered in most cases as the first treatment option for pineal tumors.
ER  -

HERNESNIEMI, Juha; R. ROMANI; BS. ALBAYRAK; H. LEHTO; R. DASHTI; C. 3rd RAMSEY; A. KARATAS; A. CARDIA; Ondřej NAVRÁTIL; A. PIIPPO; M. FUJIKI; S. TONINELLI a M. NIEMELÄ. Microsurgical management of pineal region lesions: personal experience with 119 patients. \textit{Surgical Neurology}. 2008, roč.~70, č.~6, s.~576-583. ISSN~0090-3019. Dostupné z: https://doi.org/10.1016/j.surneu.2008.07.019.

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