垂体瘤的单鼻孔神经内镜下手术治疗

目的 探讨经单鼻孔蝶窦入路神经内镜下垂体腺瘤切除手术技术.方法 回顾总结47例近期临床资料,分析术式的优缺点和克服其弊端的方法.结果 47例神经内镜下经鼻碟窦手术组肿瘤全切除39例,次全切除8例,平均手术时间85 min.后27例平均手术时间及肿瘤全切率与前20例有显著差别.结论 经单鼻孔蝶窦垂体瘤神经内镜手术技术简便、安全和有效.神经内镜手术更加微创,在经鼻碟窦入路过程及鞍区肿瘤切除方面具有优势,可提高肿瘤全切率.对该术式的技术技巧的掌握将进一步发挥神经内镜的优势.

Neuroendoseopic endonasal transsphenoidal surgery for pituitary adenomas

Objective To study surgical techniques of neuroendoscopic endonasal transsphenoidal approach for pituitary adenomas. Method 47 pituitary adenomas cases treated through endoscopic transsphenoidal approach were analyzed retrospectively. Results Total resection of adenoma was achieved in 39 cases and subtotal resection in 8 cases among neuroendoscopic technique series. The average time of operation was 85 min. There was significant difference comparing the average time of operation and degree of resection between later 27 cases and earlier 20 cases. Conclusions Unilateral endonasal transsphenoidal approach operated by neuroendoscopic techniques were convenient, safe and effective. Neuroendoscope-attached surgery could provide a more minimal invasion and excellent exposure for pituitary adenomas that result in more complete removal of tumors. Excellent application of this technique for pituitary adenomas lies on the surgical experience and judgments based on the comprebensive understanding of pathological state of disease.