经翼点入路显微切除大型垂体腺瘤

目的总结经翼点入路显微切除大型垂体腺瘤的方法及经验。方法2002年1月～2005年11月我科采用翼点入路在显微镜下切除大型垂体腺瘤39例,术中充分利用鞍区周围的各个自然解剖间隙,应用良好的显微技术切除向各方向侵袭生长的肿瘤。结果全切除34例(87.18%,34/39)、次全切5例(12.82%,5/39),全组无死亡病例。平均随访11个月,患者临床症状较术前均有不同程度改善,手术效果良好。结论经翼点入路是治疗大型垂体腺瘤的一种良好的手术入路,熟练掌握规范的手术入路和局部显微解剖以及良好的显微外科技巧是保证手术疗效的根本。

Resecting Large Pituitary Adenoma by Microsurgery through Pterional Approach

Objective To summarize the experience in resecting large pituitary adenoma by microsurgery through pterional approach. Methods Thirty-nine patients with large pituitary adenoma were treated by microsurgical operation through pterional approach in our hospital from January 2002 to November 2005. All the natural anatomical gaps and good microsurgical technique were fully used during the operation for resecting the large pituitary adenomas. Results Of 39 patients with large pituitary adenomas, 34 received total resection of the tumors and 5 subtotal. No patients died from the operation. The following-up for mean 11 months showed that the patients were improved in the clinical symptoms and the operative effect was good. Conclusions The microsurgery through pterional approach is a reliable and effective method to resect the large pituitary adenomas. Mastering the standard surgical approach,understanding the local microanatomy relative to the operation and the good microsurgical technique are the key to a good outcome of the operation in the patients with large pituitary adenomas.