额外侧锁孔入路切除大型、巨型垂体腺瘤

目的报告2000年1月至2002年12月采用额外侧锁孔入路,显微手术切除大型(最大直径20～39 mm)、巨型(≥40 mm)垂体腺瘤的方法及效果.方法 141例患者,均采用一侧眶上额下锁孔入路,进行显微手术.结果 114例(80.9%)同时达到全切肿瘤实质、切除鞍上肿瘤壁及电灼鞍内肿瘤壁的三项目的;27例为次全切.129例(91.5%)患者术后3日内可以下床活动,所有患者恢复良好,无死亡.结论本组病例表明,对大型、巨型垂体腺瘤,采用额叶外侧锁孔入路显微手术,全切率高,手术损伤少,并发症少,患者恢复良好.作者认为,对于有经验的神经外科医生而言,这是一种损伤小、安全而有效的手术方式.

Frontolateral keyhole approach for large and giant pituitary adenomas

Objective The goal of this study was to introduce the method and to evaluate the efficacy and the safety of the microsurgical craniotomy via frontolateral keyhole approach for 141 cases of large and giant pituitary adenomas between January 2000, and December 2002. Methods All patients were operated via the unilateral supraorbital subfrontal keyhole approach. The tumors were treated with microsurgical operation. Results Total removal of the tumor, excision of the suprasellar tumor wall, and coagulation of the intrasellar tumor wall were achieved in 114 cases (80.9%). 27 cases were subtotally removed. 129 cases(91.5%)can get up and walk without any aid in 3 days after operation, All of the patients recovered their health very well. There was no case died after operation. Conclusion In our experience, the frontolateral keyhole craniotomy and the microsurgical technique can improve the total removal rate, reduce iatrogenic trauma and complications, promote recovery. So, we think, the frontolateral keyhole approach for an experienced neurosurgeon is a minute, effective and safe approach for large and giant pituitary adenomas.