经蝶入路显微切除垂体巨、大型腺瘤的策略与技巧

背景与目的：垂体巨、大腺瘤是否采用经蝶手术尚有不同看法，本文总结垂体瘤手术经验，探讨经蝶入路显微切除垂体巨、大型腺瘤的理论依据、策略与技巧。方法：回顾性总结中山大学第一、第三医院收治垂体瘤的临床资料，对300例开颅术和1110例经蝶手术疗效（分三个阶段）进行对比，重点讨论经蝶手术的策略和技巧。结果：经蝶切除垂体巨、大型腺瘤全切除率高，合并症少，生活质量好。结论：经蝶显微切除垂体大、巨大型腺瘤仍是最安全有效的首次和再次手术的首选方法。

The Surgical Strategies and Techniques of Transsphenoidal Microsurgery for Large and Giant Pituitary Adenomas

BACKGROUND & OBJECTIVE: Treatment for giant as well as large pituitary adenomas has been a challenge. In this article, we are investigating the strategies and techniques of transspllenoidal microsurgery for large and gaint pituitary adenomas. METHODS: Retrospective study was performed by comparing clinical data of 300 cases of craniotomy versus 1 110 cases of transsphenoidal microneurosurgery for treatment of large and gaint pituitary adenomas. RESULTS: The total resection rate of transspllenoidal microsurgery for pituitary giant- and macro-adenoma was high and complications were lower, and the quality of life of the patients was better as compared with patient treated with craniotomy. CONCLUSIONS: Transsphenoidal microneurosurgery is an effective and safe choice for large and giant pituitary adenomas.