岛叶胶质瘤的手术策略。
Surgical strategy for insular glioma.
机构信息
Department of Neurosurgery, Ivy Brain Tumor Research Center, Barrow Neurological Institute, Phoenix, AZ, USA.
Department of Neurosurgery, University of California San Francisco, San Francisco, CA, USA.
出版信息
J Neurooncol. 2021 Feb;151(3):491-497. doi: 10.1007/s11060-020-03499-4. Epub 2021 Feb 21.
PURPOSE
The goal of this article is to review the outcomes of insular glioma surgery and discuss strategies to minimize postoperative morbidity.
METHODS
The authors reviewed the published literature on low- and high-grade insular gliomas with a focus on glioma biology, insular anatomy, and surgical technique.
RESULTS
Maximal safe resection of insular gliomas is associated with improved survival and is the primary goal of surgery. Protecting patient speech and motor function during insular glioma resection requires versatile integration of insular anatomy, cortical mapping, and microsurgical technique. Both the transsylvian and transcortical corridors to the insula are associated with low morbidity profiles, but the transcortical approach with intraoperative mapping is more favorable for gliomas within the posterior insular region.
CONCLUSIONS
Surgical strategy for insular gliomas is dependent on biological, anatomical, and clinical factors. Technical mastery integrated with intraoperative technologies can optimize surgical results.
目的
本文旨在回顾岛叶胶质瘤手术的结果，并讨论降低术后发病率的策略。
方法
作者回顾了关于低级别和高级别岛叶胶质瘤的已发表文献，重点关注胶质瘤生物学、岛叶解剖结构和手术技术。
结果
最大限度地安全切除岛叶胶质瘤与改善生存相关，是手术的主要目标。在切除岛叶胶质瘤时保护患者的言语和运动功能需要灵活运用岛叶解剖结构、皮质映射和显微手术技术。经外侧裂和皮质入路到岛叶都具有较低的发病率，但对于位于岛叶后区的胶质瘤，采用术中映射的皮质入路更为有利。
结论
岛叶胶质瘤的手术策略取决于生物学、解剖学和临床因素。技术掌握与术中技术的整合可以优化手术结果。
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