[Microsurgical treatment of craniopharyngiomas: approaches in a series of 169 consecutive patients].

OBJECTIVE

To explore the clinical features, surgical approaches and postoperative outcomes of craniopharyngiomas.

METHODS

A series of 169 consecutive cases of craniopharyngiomas undergoing microsurgical resection via various approaches at our hospital were retrospectively analyzed. There were 102 males and 67 females with a mean age of 34.1 (3-74) years. The operations were performed via unilateral subfrontal (n = 11), frontopterional (n = 69), anterior interhemispheric (n = 57), transcallosal (n = 9), transsphenoidal (n = 14), transcortical (n = 2), transventricular-foramen with neuroendoscope (n = 5) and combined (n = 2). Postoperative measures included the managements of blood sodium disorder and diabetes insipidus. During follow-ups, they were monitored for residual or recurrent tumor by postoperative contrast magnetic resonance imaging (MRI) every 1-3 months.

RESULTS

The removals of lesions were total (n = 124, 73.4%), subtotal (n = 32, 18.9%) and partial (n = 13, 7.7%). And 104 cases had an intact preservation of pituitary stalk and stalk was partially preserved in 21 patients. Visual improvement (n = 49) and deterioration (n = 21) were achieved. The major postoperative complications included diabetes insipidus (n = 101) and electrolyte disorder (n = 89). And 26 patients had recurrence during a follow-up period of 26.1 (3-66) months.

CONCLUSION

Selection of appropriate approaches according to morphological characteristics is essential for successful microsurgery of craniopharyngiomas.