脑转移瘤切除的“超边缘”理念
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深圳市第二人民医院

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Supramarginal resection of brain metastases
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    摘要:

    脑转移瘤(BM)是一些恶性肿瘤的常见并发症,手术作为神经外科治疗颅脑肿瘤最传统的方式依然发挥着不可替代的作用。颅脑转移性肿瘤的传统全切手术后往往复发率较高,越来越多的临床与病理证据支持该类肿瘤与正常脑组织并非界线分明,致使脑转移瘤的“超边缘切除”应运而生。介于脑功能的保护,应用之初仅限于非功能区,现如今已携手电生理检测、导航系统、术中唤醒等精密手段走进功能区,并基于微创理念在手术入路、瘤体切除等方面不断尝试,努力在最大范围切除肿瘤与保护脑功能之间做到最优化。通过回顾大量BM的超边缘切除相关研究,该文系统阐述了该手术理念的发生与发展。

    Abstract:

    Brain metastases (BM) are a common complication of some malignant tumours. Surgery is the most traditional form of neurosurgical treatment for cranial tumours and plays an irreplaceable role. However, the recurrence rate after conventional surgery for cranial metastases is often high. Increasing clinical and pathological evidence supports the idea that these tumours are not clearly demarcated from normal brain tissue, leading to the development of "supramarginal resection" of brain metastases. Initially limited to non-functional areas for the protection of brain function, it has now been introduced into functional areas with sophisticated tools such as electrophysiological detection, navigation systems and intraoperative arousal. Efforts have been made to optimise the relationship between maximum tumour resection and preservation of brain function, such as the surgical approach. By reviewing a large number of studies related to supramarginal resection in BM, the article systematically describes the occurrence and development of this surgical concept.

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  • 收稿日期:2022-04-12
  • 最后修改日期:2023-02-09
  • 录用日期:2022-07-25
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