显微手术切除巨大垂体腺瘤36例

目的: 介绍通过三个间隙不同手术入路应用显微技术切除巨大垂体腺瘤的经验。方法: 36例全部进行显微手术,经额下入路22例;经翼点入路13例;联合入路1例;经鼻腔蝶窦入路1例。结果: 肿瘤全切除26例;次全切除8例;部分切除2例。手术后,患者视力明显改善30例,术后出现并发症10例,其中尿崩症4例,消化道出血2例,右侧视力暂时减退4例,但10天左右视力逐渐恢复;病死1例。6个月后随访,35例症状有明显改善。结论: 经额下、翼点或联合入路时,选择其3个不同间隙切除肿瘤对切除鞍上池、额叶及向视交叉池扩展的巨大垂体瘤是较为有效的方法,具有对视神经、视交叉减压充分、肿瘤全切率高的优点。

Microsurgical removal of giant pituitary adenomas:Report of 36 cases

Objective:To introduce the experience in the microsurgical removal of giant pituitary adenomas through three approaches.Methods:Thirty-six cases of giant pituitary adenomas were treated by microsurgery.The giant pituitary adenomas were excised through subfrontal approach in 22 cases,pterion approach in 13 cases,combined approach in 1 case and nasal cavity-sphenoidal sinus approach in 1 case.Results:Of the 36 patients,26 achieved total removal of the tumors,8 subtotal removal and 2 part removal.After the operation,the eyesight was obviously improved in 30 cases.Complications occurred in 10 cases,among whom,4 suffered from diabetes insipidus,2 suffered from bleeding in stomach and the right eyesight in 4 cases got worse,but after 10 days,the eyesight revived.One case died.The fellow-up of 6 months showed that the symptoms were improved in 35 cases.Conclusions:Microsurgery by the subfrontal,pterional or combined approach is effective for the treatment of giant pituitary adenomas with a high total removal rate.