翼点入路切除哑铃形垂体腺瘤

目的 总结翼点入路显微外科手术治疗哑铃形垂体腺瘤的经验。方法 ２７例病人均经翼点入路开颅，在显微镜下解剖基底池，利用脑的自然间隙显露并切除肿瘤。结果 ２７例病人中获全切除２２例（占８１．５％），其余５例获次全切除（占１８．５％），无手术后死亡病例。对全部病例进行了１～４．５年（平均１．８年）随访观察，全切者经ＭＲＩ复查２１例未见复发，１例复发后行伽玛刀治疗。结论 翼点入路可获得良好的鞍区显露，有助于大型或巨型腺瘤的全切，是治疗哑铃形垂体腺瘤的最佳手术入路。

Microsurgical treatment of dumbell-pituitary adenoma with transpterional approach.

Objective To summarize the microsurgical operative experience of dumbell putuitary adenoma excision with transpterional approach . Methods Twenty seven patients were operated by way of the pterional craniotomy. Dissection of cisterns in sellar region was performed under microscope. Then, the natural spaces in sellar region were used to expose and remove tumors. Results Total removal of tumors were achieved in 22 cases of 27 patients (81.5%), and subtotal removal were done in 5 cases (18.5%). None died after operation. The recurrence rate was 4.5% (1/22) in the patients who had been operated with total removal of tumors. The followup ranged from 1 to 4.5 years ( mean 1.8years). Conclusion The transpterional approach is decisive in the sellar region's exposion and the large or giant pituitary adenoma's resection. It is the best operative approach in all of ways which have been used to treat the dumbell tumors.