大型鞍区肿瘤的显微外科治疗

目的探讨向鞍上及鞍旁生长的大型鞍区肿瘤的显微外科治疗效果。方法对32例经显微外科手术切除的向鞍上及鞍旁生长的大型鞍区肿瘤患者的临床资料及手术效果进行分析总结。结果垂体瘤16例,颅咽管瘤10例,脑膜瘤5例,视神经胶质瘤1例,其中20例全切,8例次全切,4例大部分切除,术中去骨瓣减压1例,无直接手术死亡病例。术前有视力视野改变的22例患者中,术后早期改善18例,无变化3例,恶化1例。随访3~42个月,术中去骨瓣减压的1例患者已行颅骨缺损修补术,未全切病例中,4例选择放射治疗,1例于术后2年行二次手术。失访4例。结论显微外科手术切除向鞍上及鞍旁生长的大型鞍区肿瘤效果良好。

Microsurgical management of giant suprasellar and parasellar lesions

Objective The aim of the study is to probe into the significance and effect of microsurgery in the resection of giant lesions located at suprasellar and parasellar regions. Methods The clinical data and surgical results of 32 cases with suprasellar and parasellar lesions were analyzed retrospectively. Results Of the 32 cases, there were 16 cases of pituitary adenomas, 10 cases of craniopharyngiomas, 5 cases of meningioms, and 1 of optic nerve glioma. Total resection and sub-total resection of the tmnor were achieved in 20 and 8 cases, respectively. Partial resection of the tumor was obtained in the left 4 cases. Decompression was performed in 1 case during the operation because of the brain edema. No death occurred postoperatively. Of 22 patients with visual improvement pre- operation, 18 patients got improvement, $ got no improvement and 1 suffered from visual deterioration. All patients were followed up for 3 to 42 months. The patient who underwent decompression during operation was performed the cranioplasty. In subtotal removal cases, 4 cases were performed the radiotherapy and 1 patient underwent the second operation at the second year because of recurrence. Four patients were missed during the follow up. Conclusion Microsurgery can bring good outcome for the resection of giant lesions located at suprasellar and parasellar regions.