Objective:This study mainly discusses the clinical effect of treating pituitary adenoma by using single nostril transsphenoidal resection of pituitary adenoma under neuro-endoscope,and analyzes the influence on hospit...Objective:This study mainly discusses the clinical effect of treating pituitary adenoma by using single nostril transsphenoidal resection of pituitary adenoma under neuro-endoscope,and analyzes the influence on hospitalization time and bleeding volume.Methods:A total of 335 patients with pituitary adenoma treated in our hospital from January 2017 to January 2019 were randomly selected for study.The patients were divided into two groups by number table method.167 patients in the reference group underwent single nostril transsphenoidal resection of pituitary adenoma under microscope.Also,168 patients in the study group underwent single nostril transsphenoidal resection of pituitary adenoma under neuroendoscope.The hospitalization time and bleeding volume and other surgical treatment effects were observed and compared.Results:There was no significant difference in the levels of prolactin(PRL),adrenocorticotropic hormone(ACTH)and thyroid stimulating hormone(TSH)between the two groups before operation(P>0.05);After surgical treatment,the levels of PRL,ACTH and TSH in the study group were lower than those in the control group(P<0.05);In terms of surgical indexes,the operation time and hospital stay in the study group were shorter than those in the reference group,and the amount of surgical bleeding was less than that in the reference group(P<0.05);The total tumor resection rate in the study group was higher than that in the reference group,and the incidence of complications such as nasal septal defect,cerebrospinal fluid leakage and diabetes insipidus in the study group was lower than that in the reference group(P<0.05).Conclusion:For pituitary adenoma diseases,using single nostril transsphenoidal resection of pituitary adenoma under neuroendoscope can improve the tumor resection rate,reduce the bleeding volume and shorten postoperative hospitalization time.展开更多
Objective:This case series study explored the application of ROSA(robot of stereotactic assistant)robotic-assisted endoscopic third ventriculostomy(ETV)in the treatment of hydrocephalus.Methods:Three patients(January2...Objective:This case series study explored the application of ROSA(robot of stereotactic assistant)robotic-assisted endoscopic third ventriculostomy(ETV)in the treatment of hydrocephalus.Methods:Three patients(January2016-October2017)diagnosed with hydrocephalus based on preoperative computed tomograph(CT)and magnetic resonance imaging(MRI)scans were recruited.Navigation planning scan was performed before operation.ROSA robot localization program was used to simulate and analyze the path planning of hydrocephalus ETV and store it in the system.All the three patients underwent robotic-assisted ETV.The patients'clinical symptoms,imaging manifestations and related complications were evaluated,and a3-month follow-up survey was conducted.Prognostic factors were also analyzed.Results:ETV under the guidance of ROSA robot was successfully performed on the three patients.CT,MRI and cerebrospinal fluid(CSF)cine showed that the ventricles were narrowed,that the velocity and flow of the stoma were normal,and that the CSF flow was smooth.After discharge,the symptoms of hydrocephalus were significantly improved.Localization of the robot and design of the surgical path were key to success of the operation.Conclusions:ROSA robotic-assisted ETV is a feasible procedure.The patients recovered well,and the symptoms relieved.More efforts are needed to optimize artificial intelligence and the application of precision treatment in the nervous system.展开更多
BACKGROUND Hypertensive intracerebral hemorrhage is a common critical disease of the nervous system,comprising one fifth of all acute cerebrovascular diseases and has a high disability and mortality rate.It severely a...BACKGROUND Hypertensive intracerebral hemorrhage is a common critical disease of the nervous system,comprising one fifth of all acute cerebrovascular diseases and has a high disability and mortality rate.It severely affects the patients’quality of life.AIM To analyze the short-term effect and long-term prognosis of neuroendoscopic minimally invasive surgery for hypertensive intracerebral hemorrhage.METHODS From March 2018 to May 2020,118 patients with hypertensive intracerebral hemorrhage were enrolled in our study and divided into a control group and observation group according to the surgical plan.The control group used a hard-channel minimally invasive puncture and drainage procedure.The observation group underwent minimally invasive neuroendoscopic surgery.The changes in the levels of serum P substances(SP),inflammatory factors[tumor necrosis factor-α,interleukin-6(IL-6),IL-10],and the National Hospital Stroke Scale(NIHSS)and Barthel index scores were recorded.Surgery related indicators and prognosis were compared between the two groups.RESULTS The operation time(105.26±28.35)of the observation group was min longer than that of the control group,and the volume of intraoperative bleeding was 45.36±10.17 mL more than that of the control group.The hematoma clearance rates were 88.58%±4.69%and 94.47%±4.02%higher than those of the control group at 48 h and 72 h,respectively.Good prognosis rate(86.44%)was higher in the observation group than in the control group,and complication rate(5.08%)was not significantly different from that of the control group(P>0.05).The SP level and Barthel index score of the two groups increased(P<0.05)and the inflam-matory factors and NIHSS score decreased(P<0.05).The cytokine levels,NIHSS score,and Barthel index score were better in the observation group than in the control group(P<0.05).CONCLUSION Neuroendoscopic minimally invasive surgery is more complicated than hard channel minimally invasive puncture drainage in the treatment of hypertensive intracerebral hemorrhage;however,hematoma clearance is more thorough,and the short-term effect and long-term prognosis are better than hard channel minimally invasive puncture drainage.展开更多
Neurosurgeons who perform intracere-bral hemorrhage(ICH)evacuation procedures have lim-ited options for monitoring hematoma evacuation and intraoperatively assessing residual-hematoma burden.In recent years,neuroendos...Neurosurgeons who perform intracere-bral hemorrhage(ICH)evacuation procedures have lim-ited options for monitoring hematoma evacuation and intraoperatively assessing residual-hematoma burden.In recent years,neuroendoscope-assisted,minimally inva-sive surgery for spontaneous ICH is simple and effective and becoming increasingly common.Many methods are applied in neuronavigation-assisted surgery for ICH evac-uation,such as neuroendoscopy,three-dimensional(3D)reconstruction,intraoperative ultrasound,and stereotac-tic craniotomy.Compared with a traditional craniotomy operation,hematoma removal(using methods of accurate localization)can reduce iatrogenic damage,protect white matter,and shorten patients’recovery time.This paper mainly outlines the treatment of basal ganglia-cerebral hemorrhage with neuroendoscopy assistance using local-ization techniques.展开更多
<strong>Objective: </strong>To explore the clinical effect of and the method and nursing strategy for sellar reconstruction for intraoperative cerebrospinal fluid (CSF) leakage in pituitary adenoma resecti...<strong>Objective: </strong>To explore the clinical effect of and the method and nursing strategy for sellar reconstruction for intraoperative cerebrospinal fluid (CSF) leakage in pituitary adenoma resection under neuroendoscopy. <strong>Methods:</strong> The data from 20 cases of intraoperative CSF leak caused by transsphenoidal pituitary adenoma resection were retrospectively analyzed. Six patients were treated with mucosal flap and artificial dural reconstruction of sellar (simple sellar floor reconstruction). In 45 patients, autologous fat, fascia lata, and artificial dura were used to repair and reconstruct the sellar floor (multilayer sellar floor reconstruction). After the operation, all patients underwent follow-up for 6 - 24 months. <strong>Results:</strong> Fifty patients were followed up without CSF leakage. One patient was cured after leakage of CSF through the lumbar cistern 1 month after discharge. <strong>Conclusion: </strong>For patients with CSF leakage during neuroendoscopic transsphenoidal pituitary adenoma resection, individualized sellar floor reconstruction should be adopted according to the degree of CSF leakage and the size of the sellar floor defect. Strict nursing measures can effectively prevent CSF leakage and reduce postoperative complications.展开更多
Objective To discuss the complicatiaons’s prophylaxis of removing pituitary adenomas by neuroendoscopy in tranasphenoidal surgery. Methods Clinical data of 253 cases treated by endoscopic endanasal transsphenoidal su...Objective To discuss the complicatiaons’s prophylaxis of removing pituitary adenomas by neuroendoscopy in tranasphenoidal surgery. Methods Clinical data of 253 cases treated by endoscopic endanasal transsphenoidal surgery were analysed. Results The total tumor removal was done in 216 (85.38%) cases,subtotal in展开更多
Neurocysticercosis is the most common central nervous system helminthic infection in humans.We hereby present a case combining two rare manifestations of neurocysticercosis:the subarachnoid and intraventricular forms....Neurocysticercosis is the most common central nervous system helminthic infection in humans.We hereby present a case combining two rare manifestations of neurocysticercosis:the subarachnoid and intraventricular forms.The patient presented with hydrocephalus and neurologic deficits and although endoscopic removal of the cysts and two cycles of postoperative cysticidal drugs resulted in resolution of symptoms,they later recurred.Ventriculoperitoneal shunt placement and a further cycle of albendazole plus dexamethasone led to substantial clinical improvement.Extraparenchymal neurocysticercosis may be challenging to diagnose and treat and is usually associated with a poorer prognosis.Clinicians should be aware of this condition.展开更多
文摘Objective:This study mainly discusses the clinical effect of treating pituitary adenoma by using single nostril transsphenoidal resection of pituitary adenoma under neuro-endoscope,and analyzes the influence on hospitalization time and bleeding volume.Methods:A total of 335 patients with pituitary adenoma treated in our hospital from January 2017 to January 2019 were randomly selected for study.The patients were divided into two groups by number table method.167 patients in the reference group underwent single nostril transsphenoidal resection of pituitary adenoma under microscope.Also,168 patients in the study group underwent single nostril transsphenoidal resection of pituitary adenoma under neuroendoscope.The hospitalization time and bleeding volume and other surgical treatment effects were observed and compared.Results:There was no significant difference in the levels of prolactin(PRL),adrenocorticotropic hormone(ACTH)and thyroid stimulating hormone(TSH)between the two groups before operation(P>0.05);After surgical treatment,the levels of PRL,ACTH and TSH in the study group were lower than those in the control group(P<0.05);In terms of surgical indexes,the operation time and hospital stay in the study group were shorter than those in the reference group,and the amount of surgical bleeding was less than that in the reference group(P<0.05);The total tumor resection rate in the study group was higher than that in the reference group,and the incidence of complications such as nasal septal defect,cerebrospinal fluid leakage and diabetes insipidus in the study group was lower than that in the reference group(P<0.05).Conclusion:For pituitary adenoma diseases,using single nostril transsphenoidal resection of pituitary adenoma under neuroendoscope can improve the tumor resection rate,reduce the bleeding volume and shorten postoperative hospitalization time.
文摘Objective:This case series study explored the application of ROSA(robot of stereotactic assistant)robotic-assisted endoscopic third ventriculostomy(ETV)in the treatment of hydrocephalus.Methods:Three patients(January2016-October2017)diagnosed with hydrocephalus based on preoperative computed tomograph(CT)and magnetic resonance imaging(MRI)scans were recruited.Navigation planning scan was performed before operation.ROSA robot localization program was used to simulate and analyze the path planning of hydrocephalus ETV and store it in the system.All the three patients underwent robotic-assisted ETV.The patients'clinical symptoms,imaging manifestations and related complications were evaluated,and a3-month follow-up survey was conducted.Prognostic factors were also analyzed.Results:ETV under the guidance of ROSA robot was successfully performed on the three patients.CT,MRI and cerebrospinal fluid(CSF)cine showed that the ventricles were narrowed,that the velocity and flow of the stoma were normal,and that the CSF flow was smooth.After discharge,the symptoms of hydrocephalus were significantly improved.Localization of the robot and design of the surgical path were key to success of the operation.Conclusions:ROSA robotic-assisted ETV is a feasible procedure.The patients recovered well,and the symptoms relieved.More efforts are needed to optimize artificial intelligence and the application of precision treatment in the nervous system.
文摘BACKGROUND Hypertensive intracerebral hemorrhage is a common critical disease of the nervous system,comprising one fifth of all acute cerebrovascular diseases and has a high disability and mortality rate.It severely affects the patients’quality of life.AIM To analyze the short-term effect and long-term prognosis of neuroendoscopic minimally invasive surgery for hypertensive intracerebral hemorrhage.METHODS From March 2018 to May 2020,118 patients with hypertensive intracerebral hemorrhage were enrolled in our study and divided into a control group and observation group according to the surgical plan.The control group used a hard-channel minimally invasive puncture and drainage procedure.The observation group underwent minimally invasive neuroendoscopic surgery.The changes in the levels of serum P substances(SP),inflammatory factors[tumor necrosis factor-α,interleukin-6(IL-6),IL-10],and the National Hospital Stroke Scale(NIHSS)and Barthel index scores were recorded.Surgery related indicators and prognosis were compared between the two groups.RESULTS The operation time(105.26±28.35)of the observation group was min longer than that of the control group,and the volume of intraoperative bleeding was 45.36±10.17 mL more than that of the control group.The hematoma clearance rates were 88.58%±4.69%and 94.47%±4.02%higher than those of the control group at 48 h and 72 h,respectively.Good prognosis rate(86.44%)was higher in the observation group than in the control group,and complication rate(5.08%)was not significantly different from that of the control group(P>0.05).The SP level and Barthel index score of the two groups increased(P<0.05)and the inflam-matory factors and NIHSS score decreased(P<0.05).The cytokine levels,NIHSS score,and Barthel index score were better in the observation group than in the control group(P<0.05).CONCLUSION Neuroendoscopic minimally invasive surgery is more complicated than hard channel minimally invasive puncture drainage in the treatment of hypertensive intracerebral hemorrhage;however,hematoma clearance is more thorough,and the short-term effect and long-term prognosis are better than hard channel minimally invasive puncture drainage.
文摘Neurosurgeons who perform intracere-bral hemorrhage(ICH)evacuation procedures have lim-ited options for monitoring hematoma evacuation and intraoperatively assessing residual-hematoma burden.In recent years,neuroendoscope-assisted,minimally inva-sive surgery for spontaneous ICH is simple and effective and becoming increasingly common.Many methods are applied in neuronavigation-assisted surgery for ICH evac-uation,such as neuroendoscopy,three-dimensional(3D)reconstruction,intraoperative ultrasound,and stereotac-tic craniotomy.Compared with a traditional craniotomy operation,hematoma removal(using methods of accurate localization)can reduce iatrogenic damage,protect white matter,and shorten patients’recovery time.This paper mainly outlines the treatment of basal ganglia-cerebral hemorrhage with neuroendoscopy assistance using local-ization techniques.
文摘<strong>Objective: </strong>To explore the clinical effect of and the method and nursing strategy for sellar reconstruction for intraoperative cerebrospinal fluid (CSF) leakage in pituitary adenoma resection under neuroendoscopy. <strong>Methods:</strong> The data from 20 cases of intraoperative CSF leak caused by transsphenoidal pituitary adenoma resection were retrospectively analyzed. Six patients were treated with mucosal flap and artificial dural reconstruction of sellar (simple sellar floor reconstruction). In 45 patients, autologous fat, fascia lata, and artificial dura were used to repair and reconstruct the sellar floor (multilayer sellar floor reconstruction). After the operation, all patients underwent follow-up for 6 - 24 months. <strong>Results:</strong> Fifty patients were followed up without CSF leakage. One patient was cured after leakage of CSF through the lumbar cistern 1 month after discharge. <strong>Conclusion: </strong>For patients with CSF leakage during neuroendoscopic transsphenoidal pituitary adenoma resection, individualized sellar floor reconstruction should be adopted according to the degree of CSF leakage and the size of the sellar floor defect. Strict nursing measures can effectively prevent CSF leakage and reduce postoperative complications.
文摘Objective To discuss the complicatiaons’s prophylaxis of removing pituitary adenomas by neuroendoscopy in tranasphenoidal surgery. Methods Clinical data of 253 cases treated by endoscopic endanasal transsphenoidal surgery were analysed. Results The total tumor removal was done in 216 (85.38%) cases,subtotal in
文摘Neurocysticercosis is the most common central nervous system helminthic infection in humans.We hereby present a case combining two rare manifestations of neurocysticercosis:the subarachnoid and intraventricular forms.The patient presented with hydrocephalus and neurologic deficits and although endoscopic removal of the cysts and two cycles of postoperative cysticidal drugs resulted in resolution of symptoms,they later recurred.Ventriculoperitoneal shunt placement and a further cycle of albendazole plus dexamethasone led to substantial clinical improvement.Extraparenchymal neurocysticercosis may be challenging to diagnose and treat and is usually associated with a poorer prognosis.Clinicians should be aware of this condition.
