Microsurgical experience with pediatric craniopharyngiomas

WANG Guo-liang; LI Tian-dong; GAO Han; GONG Fang-he; ZHANG Xiao-peng

Abstract：Objective To explore the key elements of microsurgical procedure and peri-operative management of pediatric craniopharyngiomas.Methods The clinical data of 32 cases of pediatric craniopharyngiomas were retrospec-tively analyzed for microsurgical strategy and therapeutic results.Results Total resection of tumor was achieved in 20 ca-ses,subtotal in 10 cases and partial in 2 cases.Pterional approach was applied in 14 cases with 7 cases of total resection,6 cases of subtotal resection and 1 case of partial resection.Transsubfrontal-translongitudinal approach was applied in 18 cases,with 13 cases of total resection,4 cases of subtotal and 1 case of partial resection.Eighteen cases had good recov-ery,12 cases had improved condition and 2 cases died after surgery.The most common complication was disorders of wa-ter and electrolyte metabolism.Of the 18 followed-up cases,6 cases presented tumor recurrence,and were in stable con-dition after second operation.Conclusion Total removal of tumor with microsurgical technique is the key factor that de-termines the prognosis of pediatric cyraniopharyngiomas.A good exposure is an important factor to achieve total excision of the tumor and sparing of the hypothalamus,and transsubfrontal-translongitudinal approach can help with exposure of cra-niopharyngiomas.Management of water and electrolyte disorders and hormone supplement during peri-operative period is also very important.