Microsurgical treatment of tumors in third ventricle

Objective To investigate the surgical approaches and techniques of microsurgical treatment for tumors in the third ventricle.Methods A total of 36 patients with third ventricular tumors were treated by microsurgery using different surgical approaches.Fifteen cases were performed by transcallosal approach(10 cases by transforaminal approach and 5 cases by interforniceal approach),8 cases by infratentorial supracerebellar approach,8 cases by trans-lamina terminalis approach and 5 cases through superior frontal gyrus.Post-operative hydrocephalus happened in 7 cases.Treatment included ventriculoperitoneal shunting(V-P shunting) in 3 cases,third ventriculostomy in 1 case and septostomy in 1 case with lateral cerebral ventricle enlargement.The other 2 cases gave up further treatment.Results Total removal was achieved in 22 cases,subtotal removal in 8 cases,and partial resection in 6 cases.Three-month follow-up showed that there were good effect in 33 patients,poor effect in 1 patient and 2 patients died.Long-term follow-up(3 months to 7 years) showed that good effects were achieved in 26 cases and 8 patients died.Eleven patients need long-term endocrine replacement therapy.Conclusion Resection of third ventricle tumors is difficult,but combination of suitable surgical approach and experienced microsurgical techniques can gain good curative effects.