Anatomy and surgery of pure neuroendoscopic infratentorial supracerebellar approach for resection of pineal region tumor

Abstract

Background: The pineal region tumors are surrounded by important structures. Neuroendoscopy has been increasingly used at home and abroad. This study is to simulate pure neuroendoscopic infratentorial supracerebellar approach for resection of pineal region tumor from the cadaveric head, and discuss the advantages and safety through this corridor. Methods: The anatomical structure for resection of pineal region tumor was visualized through pure neuroendoscopic infratentorial supracerebellar approach in three cadaveric heads. Three cases with pineal region tumors were retrospectively analyzed and summarized between June 2017 and December 2017. All cases were operated through pure neuroendoscopic infratentorial supracerebellar approach in the first affiliated hospital of Fujian medical university. Results: The anatomical structures of pineal region can be completely visualized by pure neuroendoscopic infratentorial supracerebellar corridor in the cadaveric head. Among the three cases, the first case was total resection, the second case was subtotal resection and the last case was partial resection. The postoperative pathology revealed cavernous hemangioma, germinoma and yolk sac tumor, respectively. The patients were followed-up for 1-6 months and had normal life.The KPS (karnofsky performance status) score was 100. Conclusion: The anatomical structure of the pineal region can be completely visualized and the tumor can be safely removed through pure neuroendoscopic infratentorial supracerebellar approach.

Treatment of Pineal Region Lesions in Children

“…Moreover, some surgeons are of the opinion that larger lesion size is a contraindication to resection (Supplemental Table 1, Supplemental Digital Content 1, http://links.lww.com/SCS/F651 and Fig. 1), especially endoscopic-assisted surgery 24,25 . Moderate-sized lesions (<3 cm) are optimal for endoscopic-assisted surgery and are optimal for total resection, which in turn leads to better outcomes 26,27 .…”

“…1), especially endoscopic-assisted surgery. 24,25 Moderate-sized lesions (< 3 cm) are optimal for endoscopicassisted surgery and are optimal for total resection, which in turn leads to better outcomes. 26,27 In the current study lesion size > 3.15 cm was an independent predictor of poor prognosis (Fig.…”