神经内镜下经单鼻腔蝶窦入路切除垂体腺瘤

目的总结神经内镜下经单鼻腔蝶窦入路切除垂体腺瘤的手术经验,探讨该手术方式的优越性。方法对187例垂体腺瘤采用经右鼻腔蝶窦入路手术,手术全过程在神经内镜下进行。结果脑脊液漏5例,颅内感染2例,术后17 d鼻腔大出血1例。随访3～35个月,MR复查示肿瘤全切除133例,近全切除32例,部分切除20例,活检2例。结论神经内镜下经单鼻腔蝶窦入路切除垂体腺瘤,手术入路最为直接,手术时间短,创伤小,术中视野广,术后恢复快,并发症较少。

Endoscopic transnasal transsphenoidal pituitary surgery

Objective To summarize the surgical experience of endoscopic transnasal transsphenoidal pituitary surgery and discuss its advantages. Methods 187 cases were performed with transnasal transsphenoidal pituitary surgery. The whole process of the surgery was finished under the neuroendoscope. Results CSF leak occurred postoperatively in 5 cases, intracranial infection occurred in 2 cases, serious nasal bleeding occurred in 1 case 17 days after operation. All patients had been followed-up for 3 to 35 months. Judged according to the postoperative MRI, the tumors were removed totally in 133 cases, subtotally in 32 cases, partially in 20 and biopsy in 2 of 187 cases. Conclusion The approach of endoscopic transnasal transsphenoidal surgery has the advantages in resecting pituitary adenoma: simple surgical process, shorter operation time, minimal invasion, good field of vision during surgery, faster comeback and less postoperative complication. It is a good method in resecting pituitary adenomas.