Clinical application of the transcallosal-septum-interforniceal approach

Objective To investigate the surgical indications, advantages and disadvantages of microsurgical resection of three intraventricular tumors through the transcallosal-septum-interforniceal approach, and to discuss the correlative microsurgical anatomy and treatment of postoperative complications. Methods The clinical data of 42 patients with three intraventricular tumors who underwent microsurgical resection from September 2004 to August 2017 were retrospectively analyzed. Analysis of how to prevent intraoperative complications and postoperative management. Results Total resection was achieved in 37 cases, total resection rate was 88.1%, near total and subtotal resection in 5 cases, and no deaths. The main complications were diabetes insipidus (23 cases), electrolyte disorder (17 cases), central high fever (11 cases), treated from 1 to 2 weeks to disappear; forehead subdural pneumatosis (7 cases), frontoparietal subdural effusion (3 cases), were treated by conservative treatment on their own absorption and disappeared; postoperative short-term memory loss, spatial resolution decreased in 3 cases, both in the 3 months of recovery. Postoperative long-term complications included hydrocephalus in 1 patient and ventriculoperitoneal shunt in 3 months after operation. All patients were followed up for 3-64 months, 37 cases of total resection, postoperative follow-up period of cranial MRI showed no tumor residual and recurrence; not total resection of 5 cases underwent stereotactic radiotherapy, 3 cases increasing with tumor size, treated with gamma knife. Conclusion The transcallosal-septum-interforniceal approach for microsurgically removing the third ventricle tumors is a slight trauma, can provide clear and the quite large operation field, and the total resection rate is high, and the postoperative complications are less, which is the ideal approach to microsurgical resection of three intraventricular tumors. Key words: Transcallosal interforniceal approach; Third ventricle; Tumor; Microsurgery