Abstract
Objective To discuss the surgical strategy and therapeutic effect of neuroendoscopic resection of meningiomas in lateral ventricular trigonum. Methods A retrospective analysis of 5 cases with meningiomas in lateral ventricular trigonum was conducted, who were diagnosed and underwent operations in Department of Neurosurgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine from March 2015 to November 2015. All patients underwent preoperative thin-section computed tomography (CT) scans and contrast-enhanced magnetic resonance imaging (MRI). For large intraventricular meningiomas, examinations including computed tomography angiography (CTA), magnetic resonance angiography (MRA) and digital subtraction angiography (DSA) as well as partial vascular interventional embolization were desirable in order to deal with the tumor feeding artery as soon as possible. In the whole process of operation, tumors were resected under the neuroendoscope assisted by neuronavigation, ultrasonic suction system, and a novel brain retractor device. Results The meningiomas in lateral ventricular trigonum in all 5 cases were resected completely and were pathologically determined to be fibrous meningiomas. The immunohistochemical analysis showed that Ki-67 index was lower than 1%. The surgical channels were well healed with no brain edema in operation area or ventricle enlargement. Compared with 8 similar patients in other treatment modalities, the mean hospitalization time was significantly shorter [(17.5±4.3) d vs (11.0±2.9) d]. No complications, such as epilepsy, hydrocephalus or visual field defects, were observed postoperatively during the follow-up lasting 6 months to 1 year. Conclusion The neuroendoscope combined with neuronavigation, ultrasonic suction system and the novel brain retractor device could help accurately locate deep intracranial tumors, facilitate real-time intraoperative protection of surrounding vessels and functional structures, and achieve maximal safe resection of tumors. Key words: Meningioma; Lateral ventricle; Neuroendoscopy; Neuronavigation; Treatment outcome
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