目的:弥漫性内在脑桥胶质瘤(DIPGs)容易发生高手术风险,他们甚至可能因为他们的特定地点而导致死亡。为了确定DIPG的无框架机器人辅助立体定向活检的价值,与显微外科活检相比。
方法:我们对2016年1月至2021年1月接受活检的71例儿科患者进行了回顾性研究。(i)第1组:显微外科活检,和(ii)第2组:无框机器人辅助的立体定向活检。人口统计信息,神经影像学特征,病理诊断,操作时间,术后重症监护病房(ICU)停留时间,术后住院时间,并发症,成本,收集围手术期死亡率(POMR)进行分析.
结果:32例行显微活检(第1组),39例行无框机器人辅助立体定向活检(第2组)。所有病例均在手术后得到准确诊断。性别差异无统计学意义,年龄,两组患者的症状次数和肿瘤体积(P>0.05);手术时间,术后ICU,第1组的住院时间和术后住院时间长于第2组(p<0.001);第1组的术中出血量和手术费用高于第2组(p<0.001).第1组患者需要更多的围手术期输血比第2组(p=0.001),第1组比第2组更常见新的神经损伤(p=0.003)。第1组POMR为9.38%(3/32),第2组POMR为0(p=0.087)。
结论:无框架机器人辅助立体定向活检是一种有效且微创的小儿DIPG技术。
OBJECTIVE: Diffuse intrinsic pontine gliomas (DIPGs) are prone to high surgical risks, and they could even lead to death due to their specific sites. To determine the value of frameless robot-assisted stereotactic biopsies of DIPGs, when compared it with microsurgical biopsies.
METHODS: We conducted a retrospective study of 71 pediatric patients who underwent biopsies from January 2016 to January 2021. (i) group 1: microsurgical biopsies, and (ii) group 2: frameless robot-assisted stereotactic biopsies. Demographic information, neuroimaging characteristics, pathological diagnoses, operation time, postoperative intensive care unit (ICU) stay time, postoperative hospitalization time, complications, cost, and perioperative mortality rate (POMR) were collected for analyses.
RESULTS: 32 Cases underwent microsurgical biopsies (group 1) and 39 cases underwent frameless robot-assisted stereotactic biopsies (group 2). All cases were accurately diagnosed after surgery. There was no significant difference in gender, age, symptom times and tumor volumes between the two groups (p > 0.05); operation time, postoperative ICU, stay time and postoperative hospitalization time were longer in group 1 than in group 2 (p < 0.001); the intraoperative bleeding volumes and cost were higher in group 1 than in group 2 (p < 0.001). Group 1 patients required more perioperative blood transfusion than group 2 (p = 0.001), and the new neurological impairments were more frequent in group 1 than in group 2 (p = 0.003). The POMR was 9.38% (3/32) in group 1 and 0 in group 2 (p = 0.087).
CONCLUSIONS: Frameless robot-assisted stereotactic biopsy was an effective and minimally invasive technique for pediatric DIPGs.