ATPS-53SURGICAL THERAPY FOR CEREBRAL VENTRICLE TUMOR IN INFANTS

Abstract

BACKGROUND: Surgical treatment for infant ventricle tumors is a tough procedure. We summarize the clinical information, surgical experience and perioperative therapy for 14 patients. METHODS: The patients contained 8 males, 6 females and were treated from 2010-1 to 2014-12. The age ranged from 4 to 24 months with an average of 11.5 months. We used the approach of trigone area for 3 cases, interhemispheric transcallosal for 5 cases, and sub-occipital medline for 6 cases. RESULTS: Resection extent: 10 total resection (including 2 subtotal resection), 4 partial resection. Pathology categories: 5 choroid plexus papilomas (CPP), 1 choroid plexus carcinoma,1 mature teratoma, 1 anaplastic CPP, 3 anaplastic ependymoma (WHO III), 1 ependymoma (WHO I-II ), 1 glioma, 1 medulloblastoma. PROGNOSIS: 7 cases survive (4 cases survive with different complications); 5 infants died (all died for abandoning treatment); 1 case was lost. Overall, the prognosis is poor. CONCLUSIONS: 1. Infant cerebral ventricle tumors are often large before symptoms come up. Tumor's proximity to important brain regions makes it difficult for total resection. 2. Infants have a small blood volume and poor tolerance to operation, since great blood loss usually occurs intraoperation. Time-consuming operations, such as those for total resection, require a great deal of time under anaesthesia and blood loss. It's preferable to choose a stage operation when severe blood loss occurs. 3. Acute resection is a better choice to relieve hydrocephalus rather than drainage. 4. Close contact of qualified, specialist medical staff is necessary. Intensive care and nutritional support are important for postoperation therapy.