扩大经蝶窦入路切除侵袭性垂体腺瘤

目的探讨采用扩大经蝶窦入路切除侵袭性垂体腺瘤的有效性和安全性。方法根据鞍区显微解剖学研究结果,采用扩大经蝶窦手术入路治疗64例侵袭性垂体腺瘤。结果肿瘤全部切除51例,次全切除13例。术后发生短暂性尿崩症26例,脑脊液鼻漏5例及急性腺垂体功能低下者1例,无死亡及颅内感染。8例患者术后给予放射治疗,6例予以溴隐亭治疗。随诊3个月至6年,未见肿瘤复发或继续生长。结论采用扩大经蝶窦入路切除巨大或不规则鞍外生长垂体腺瘤时,肿瘤显露满意,全切除率高,无明显手术并发症,是一种安全、有效的方法。对于那些肿瘤切除不彻底的患者,术后应密切随访,必要时给予放射或药物治疗。

Extended transsphenoidal operation for giant and invasive pituitary adenomas

Objective To evaluate the possibility of extended transsphenoidal approach for removing the giant and invasive pituitary adenomas. Methods The clinical data of 64 cases with giant and invasive pituitary adenoma treated by extended transsphenoidal approach were studied retrospectively. Results Among 64 patients, 51 had total resection and 13 had subtotal resection. 26 patients occurred transient diabetes insipidus, 5 patients with transient cerebrospinal rhinorrhoea and 1 patient occurred acute hypopituitarism postoperatively. There were no death or intracranial infection. After operation, 8 patients get radiothorapy, 6 patients receive medicine treatment. Postoperative follow-up period was 3 months to 6 years. No regrowth or recurrence was seen. Conclusion The extended transsphenoidal approach has been proved to a safe and effective method to remove the giant and invasive pituitary adenomas. Patients who got subtotal resestion need be close followed-up and receive radiothercopy or medicine treatment it necessary.