Summary
This paper reports the results of 27 choroid plexus papillomas surgically treated, out of 28 cases observed in the authors insitute during the period 1952–1978. These were divided into two groups: a) those operated on before 1969; b) those operated on in 1969 and the following years, when microsurgical facilities were routinely employed. As a rule, neither ventricular shunting nor radiation therapy were used preoperatively. A total removal was attempted in all cases, and performed in all but three. The second group (1969–1978) showed better results as regards the number of totally removed tumours (92% against 87%), surgical deaths (16% against 31%), and long-term good results (67% against 44%). Considering both groups together, long-term good results were achieved in 15 patients (55%), followed up from 2 to 27 years. Radical operation is the treatment of choice for choroid plexus papilloma. As indicated by the author's experience, this produces satisfactory long-term results, whilst surgical mortality can be held within acceptable limits, provided that modern techniques are used properly. The value of radiation therapy, which in any event should be restricted to malignant cases, remains questionable.
Zusammenfassung
In der Arbeit wird über das operative Behandlungsergebnis von 27 Plexuspapillomen aus einer Serie von 28 Fällen berichtet, die zwischen 1952 und 1978 im Neurochirurgischen Institut der Universität Rom behandelt wurden. Eine Gliederung erfolgte in 2 Gruppen: a) vor 1969 und b) nach 1969 mit routinemäßiger Durchführung der Mikrochirurgie.
Ventrikuläre Shunt-Operationen und Röntgentherapie wurden praeoperativ nicht vorgenommen. Eine Totalentfernung des Tumors wurde stets angestrebt und mit Ausnahme von 3 Fällen durchgeführt.
In der mikrochirurgisch operierten Gruppe (1969–1978) war das Ergebnis deutlich besser. 92% wurden total extirpiert gegenüber 87% in der Gruppe a). Es verstarben postoperativ 16% gegenüber 31%. Die Spätergebnisse waren mit 67% besser als in der ersten Gruppe mit 44%. Insgesamt hatten 14 Kranke (55%) ein gutes Spätresultat mit Nachuntersuchungen nach 2 bis 27 Jahren.
Die radikale Entfernung ist die Methode der Wahl in der Behandlung der Plexuspapillome. Die eigenen Erfahrungen zeigen, da– sie zu zufriedenstellendem Spätergebnis bei akzeptabler Operationsmortalität führt. Voraussetzung ist die Beherrschung der modernen Operationstechnik. Die Bedeutung der Radio-Therapie bleibt fraglich. Sie sollte ausschließlich auf maligne Fälle beschränkt bleiben.
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Guidetti, B., Spallone, A. The surgical treatment of choroid plexus papillomas. Neurosurg. Rev. 4, 129–137 (1981). https://doi.org/10.1007/BF01743638
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DOI: https://doi.org/10.1007/BF01743638