Microsurgery via posterior interhemispheric transtentorial approach for patients with pineal region tumors
YI Meng
SHAO Lingmin
LIU Renzhong
Abstract：Objective To explore the surgical techniques and outcomes of resecting pineal region tumors via the poste-rior interhemispheric transtentorial approach.Methods A retrospective analysis was conducted on the clinical data of 21 patients with pineal region tumors who underwent microsurgery via the posterior interhemispheric transtentorial approach in the Department of Neurosurgery,Renmin Hospital of Wuhan University,between January 2014 and January 2022.Results Postoperative cranial MRI examinations at 1～3 months showed total resection in 19 cases and subtotal resection in 2 cases.Postoperative pathological results indicated 10 cases of germ cell tumors,5 cases of pineocytoma,4 cases of astrocytoma,1 case of glioblastoma,and 1 case of small cell neuroendocrine carcinoma(of pulmonary origin).Postoperatively,1 patient developed contralateral parietal epidural hematoma,which was surgically evacuated with good recovery.New-onset upward gaze palsy occurred in 2 cases and diplopia in 3 cases,both resolving within 3 months postoperatively.Eight patients underwent external ventricular drainage before tumor re-section,and 4 patients underwent third ventriculostomy after tumor resection during the same surgery.No visual field deficits were observed postoperatively,and follow-up cranial CT scans showed no occipital lobe edema or contusion.Postoperative follow-up ranged from 6 to 36 months,with all 21 patients surviving.Three patients required ventriculoperitoneal shunting after tumor resec-tion,and tumor recurrence occurred in 6 cases.Conclusion Microsurgery is an important treatment modality for pineal region tumors.Patients with benign or low-grade malignant lesions can achieve long-term survival after surgical resection.For highly ma-lignant tumors,maximal safe resection followed by adjuvant radiotherapy and chemotherapy can prolong patient survival.
Keywords：pineal region tumorsposterior interhemispheric transtentorial approachmicrosurgeryefficacy
Publication Date：2025-11-25
Online Publishing Date：2026-01-12(First online date of this platform, not the publication date of the document)
Pages：5( 649-653 )