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目的 探讨边缘系统低级别胶质瘤应用显微手术广泛性切除的可行性及其效果。方法 回顾分析我院1995年2月至2000年12月应用显微手术广泛性切除的38例边缘系统低级别胶质瘤,就其疗效进行随访研究。结果 肿瘤全切除21例,次全切除12例,部分切除5例。术后无1例死亡,8例术后出现短暂性失语和反应迟钝,5例发生命名性失语,2例术后癫痫小发作,28例术后恢复良好,头颅CT或MRI检查无肿瘤残存征象。30例获得随访,56％的病例2年内未见复发。结论 边缘系统低级别胶质瘤起源于异生皮层和中间皮层,通过显微手术广泛性切除肿瘤而不致损伤重要功能结构,术后辅以放疗可明显延长生存期。
Objective To investigate the feasibility and effect of extensive microsurgical resection of low grade gliomas in the limbic system. Methods We retrospectively analyzed 38 cases of low-grade gliomas of the marginal system that were extensively removed by microsurgery from February 1995 to December 2000 in our hospital. Follow-up studies were conducted on their efficacy. Results Total tumor resection was performed in 21 cases, subtotal resection in 12 cases and partial resection in 5 cases. No postoperative death occurred. Eight patients had transient aphasia and unresponsive postoperatively. Five patients developed naming aphasia. Two patients had epileptic seizures. 28 patients recovered well after surgery. CT or MRI showed no signs of residual tumors. . Thirty patients were followed up, and 56% had no recurrence within 2 years. Conclusion The low-grade glioma of the limbic system originates from the heteroepithelium and the middle cortex. Extensive resection of the tumor by microsurgery does not result in injury of important functional structures. Postoperative radiotherapy supplementation can significantly prolong survival.