INC德国Schroeder教授关于神经内镜经鼻入路治疗颅咽管瘤的解析
INC国际神经外科医生集团、国际神经内镜联合会执行委员会主席Henry W. S. Schroeder教授关于神经内镜治疗颅咽管瘤的论文交流：Endoscopic Endonasal Approach for Craniopharyngiomas（神经内镜经鼻入路治疗颅咽管瘤）
Craniopharyngiomas (CPs) represent one of the most challenging tumor entities in neurosurgery. Because of its critical vicinity to important neurovascular structures, the surgery is demanding and requires a thorough understanding of the anatomy of the suprasellar region. CPs are benign epithelial tumors of the sellar region originating from remnants of Rathke’s cleft. They are classified by the World Health Organization as grade I neoplasms.1 The papillary form is almost exclusively found in the adult population and the adamantinomatous subtype mainly occurs in children.
There is a bimodal age distribution of the incidence of CPs with a higher amplitude in childhood. However, the prognosis of these tumors in particular is a matter of growth pattern. The extent of the tumor in relation to the optic chiasm, pituitary gland and stalk, hypothalamus, carotid artery, and anterior cerebral artery complex as well as the location of the tumor with respect to the sella and diaphragm, is important for surgical planning. In addition to the tumor size and the multilobulated characteristics with solid and cystic components, it is of significant interest whether the lesion does extend into the third ventricle or not and its relation to it. To solve the problem of choosing the right surgical strategy for individual cases, a variety of topographic and clinical classifications of CPs have been transferred into surgical practice parallel to technological progress of instrumentation and equipment。
There is a bimodal age distribution of the incidence of CPs with a higher amplitude in childhood. However, the prognosis of these tumors in particular is a matter of growth pattern. The extent of the tumor in relation to the optic chiasm, pituitary gland and stalk, hypothalamus, carotid artery, and anterior cerebral artery complex as well as the location of the tumor with respect to the sella and diaphragm, is important for surgical planning. In addition to the tumor size and the multilobulated characteristics with solid and cystic components, it is of significant interest whether the lesion does extend into the third ventricle or not and its relation to it. To solve the problem of choosing the right surgical strategy for individual cases, a variety of topographic and clinical classifications of CPs have been transferred into surgical practice parallel to technological progress of instrumentation and equipment。
颅咽管瘤（CPs）代表着神经外科中较具挑战性的肿瘤实体之一。由于其紧邻重要的神经血管结构的关键区域，因此外科手术的要求很高，并且需要完全了解鞍上区域的解剖结构。 CPs是源自Rathke裂隙残留的鞍区良性上皮肿瘤。它们被国际卫生组织归类为I级肿瘤。1乳头状形式几乎仅在成年人口中发现，金刚菌亚型主要发生在儿童中。儿童期CP的发病率呈双峰年龄分布，幅度更大。但是，这些肿瘤的预后取决于生长方式。肿瘤的程度与视交叉、脑垂体、下丘脑、颈动脉和大脑前动脉复合体以及肿瘤相对于蝶鞍和diaphragm肌的位置对于手术计划很重要。除了肿瘤的大小和具有实体和囊性成分的多叶特征外，病变是否确实伸入三脑室及其关系也引起了人们的较大兴趣。为了解决针对个别病例选择正确的手术策略的问题，与仪器和设备的技术进步并行的是，颅咽管瘤的各种地形和临床分类已被转移到手术实践中。
关于INC德国Henry W. S. Schroeder教授
INC德国Schroeder教授对于神经内镜经鼻治疗颅咽管瘤的优势总结：
鼻内镜治疗颅咽管瘤的方法越来越多被用作显微外科经蝶或经颅入路的替代方法。
由于好转了这些困难的病灶，这种方法是迈出了重要的一步切除率和更好的视觉效果。
是在后交叉性肿瘤中，鼻内入路可更好地进入病变并且降低了光学设备的操纵程度。
内窥镜提供的全景视图以及使用成角度的光学器件可以去除病变延伸至三脑室，避免显微外科手术脑裂。
INC (International Neurosurgeon’s Circle) 是一个专注于神经外科领域专家学术交流的医生集团。国际神经外科顾问团（World Advisory Neurosurgical Group，WANG）是INC旗下的一个纯外籍的、国际高水准的神经外科教授团，其成员均是来自欧洲、美国、日本等发达国家神经外科不同细分领域的教科书级别专家。INC一直致力于中外神经外科技术的交流、合作、促进和提高，同时针对高要求人群及脑肿瘤手术病例，提供国际治疗咨询与协调服务。
11月9日，2019二届INC国际神经外科顾问团（WANG）年度峰会将在上海外滩源壹号（原英国驻沪总领事馆）开幕。此次峰会以外，INC还将组织旗下14位国际神经外科专家为国内患者同期开放现场咨询及国内手术，脑胶质瘤、脑海绵状血管瘤、脑膜瘤、听神经瘤、垂体瘤、脊髓肿瘤、小儿癫痫、脑积水、帕金森、面肌痉挛以及脑动脉瘤、脑动静脉畸形等神经系统疾病患者均可报名参与，寻求这些国际教授提供的咨询意见，获取国际水平的前沿咨询策略和手术方案。
此次现场咨询之外，部分有手术指征的患者还可接受由INC国际颅底肿瘤手术教授/平均手术切除率在90%以上的德国巴特朗菲教授、国际神经内镜“教授”/“筷子手法”提出者法国Sebastien Froelich教授在苏州大学附属儿童医院和浙江大学医学院附属邵逸夫医院亲自主刀的顺利高切除手术。
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