Radical surgical treatment of pineal region tumors: report of 158 cases

Abstract

Objective To investigate surgical strategies and key techniques of pineal region tumors.Methods The records of 158 patients with pineal region tumors surgically removed by occipital transtentorial approach,including their clinical data,surgical methods and follow-up results,were retrospectively reviewed.Results A gross total tumor removal was accomplished in 137 patients (86.7％),subtotal in 19 (12.0％),and partial in 2 (1.3％).The histological diagnosis was germ cell tumor in 52.5％,pineal parenchymal tumor in 11.4％,glioma in 18.4％ and miscellaneous in 17.7％.The mortality and permanent morbidity were 1.9％ and 18.4％,respectively.Early or delayed hydrocephalus occurred in 19 cases.Conclusions Radical surgery plays an important role in the management of pineal region tumors.Reasonable approach selection,developed knowledge about arachnoid membranes and deep veins in pineal region,and skilled microsurgical techniques are critical to achieve a safe tumor removal. Key words: Occipital transtentorial approach; Pineal region tumors; Microsurgery