Artikel
The endoscopic biopsies in the tumors of the posterior part of the third ventricle
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Autoren
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A. Morsli
- Service de Neurochirurgie, CHU de Babeloued Alger, Algerie
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M. Aitbachir
- Service de Neurochirurgie, CHU de Babeloued Alger, Algerie
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N. Lagha
- Service de Neurochirurgie, CHU de Babeloued Alger, Algerie
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T. Benbouzid
- Service de Neurochirurgie, CHU de Babeloued Alger, Algerie
| Veröffentlicht: | 4. Mai 2005 |
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Gliederung
Text
Objective
The lesions localized to the level of posterior part of the third ventricle are often tumors to starting point of the region surrounding this partitions to know the pineal region, the midbrain and the thalamus, the direct surgical access is not deprived of risk and the extraction is often partially; since these lesions are associated to a hydrocephaly sorting by obstruction of the aqueduct of Sylvius us propose an endoscopic biopsy associated to the ventriculocisternostomy.
Methods
One period of one year we took in loads four patients; the middle ages is 28 years with same sex ratio, the motivates of consultation is the headache; the MRI recovered has lesion to starting dawns of pineal region, of the midbrain, has lesion of the floor of the V3 obstructing the aqueduct of Sylvius and the multiple injured of the floors of the V3. A hydrocephaly sorting was always associated to these lesions. Our patients have been operated, a tréphine of 3cm has been used and that for easiness the antéropostériorly progression of the endoscope of the previous walls of the V3 sits of the ventriculocistérnostomy until the partitions posterior sits of the biopsy.
Results
On the clinical plan the results were good as regards to the headache, whereas the survey anatomopathologique recovered a glioma of low rank in the case of the tumor of the pineal region, a metastasis of an adénocarcinoma in the case of the multiples lesions; an oncologic treatment has been practiced for these two patients; a fibrillar astrocytoma Gde1 and an pilocytique astrocytoma have been recovered in the two other cases, the IRM surveillance has been recommended for these patients.
Conclusions
The endoscopy has revolutionize the handling of some pathologies of the V3 of which the hydrocephaly sorting especially if the one there is has a lesion obstructing the aqueduct of Sylvius, in only one time one practices the VCS and the biopsy to the level of the posterior parts of the V3, some obstacles can prevent to make these two gestures in only one operative time and the survey IRM is primordial.
