Surgical treatment strategies for the middle third of parasagittal meningioma

Abstract

Objective To investigate the methods of effective removal of the middle third parasagittal meningioma in order to improve its clinical efficacy and decrease the postoperative complications. Methods The tumors were resected with a relatively conservative strategy by using lateral supine and preserved the superior sagittal sinus and draining veins as much as possible. When tumor residues were obvious and progressive during the follow-up period, they were given adjuvant radiation therapy. Finally, the clinical data including surgical effect and postoperative complications were analyzed statistically. Results Of the 124 patients, 96 (77.4%) achieved total resection; 28 (22.6%) achieved subtotal resection. They were followed up for 6 to 60 months after procedure, 13 (10.5%) had recurrence, including 9 females (12.2%) and 4 males (9.3%). Nine patients (9.4%) of total resection had recurrence, 4 (14.3%) of total resection had recurrence. There was no significant difference in the recurrence rate between the different genders (P>0.05). There was no significant difference in the recurrence rate between the patients of total resection and those of subtotal resection (P>0.05). After procedure, 120 patients recovered well and returned to work. Two (1.6%) had disability, but they could take care of themselves. Two patients (1.6%) died, one died of pulmonary embolism and the other died of myocardial infarction. Conclusions Using lateral supine and microsurgical techniques are conducive to the resection of tumors while protecting the draining veins and cerebral cortices. Preserving the patency of the superior sagittal sinus and draining vein as much as possible may reduce the postoperative mortality and disability. If necessary, using radiotherapy after procedure can also achieve good long-term efficacy. Key words: Meningioma; Superior sagittal sinus; Neurosurgical procedures