Endoscopic transsphenoidal treatment of pituitary adenomas
Endoscopic transsphenoidal treatment of pituitary adenomas
复制标题
内镜下经蝶治疗垂体腺瘤
DOI：
10.1179/174313208x298110
复制
发表时间：
2008-07-01
影响因子：
1.9
通讯作者：
Piao, Mingxue
中科院分区：
文献类型：
--
作者：
Zhang, Yazhuo;Wang, Zhongcheng;Piao, Mingxue
目的：探讨内镜下经鼻蝶手术治疗垂体腺瘤的技术和方法。方法：2000年5月至2006年5月，我院采用内镜下经蝶手术治疗垂体腺瘤678例。所有病例均经鼻中隔至中鼻甲之间经鼻蝶入路手术，首先手术至扩大的蝶骨。 用高速钻将窦口和鞍底打开，然后逐步切除肿瘤。 62%的病例（420例）获得了6-24个月的随访。 结果：678例垂体腺瘤中，肿瘤全部切除543例（80.1%），次全切除118例（17.4%），部分切除17例（2.5%）。 98%（655例中的643例）术后临床症状得到一定程度的改善。 21例（3%）发生术后并发症（包括蛛网膜下腔出血、鼻腔出血、鼻孔感染、鼻翼变形、脑脊液鼻漏）。 420例随访患者中，有4例在首次手术后2年后肿瘤复发。结论：内镜下经蝶垂体腺瘤手术是一种微创、有效、安全、操作简单的微创神经外科技术，是一种有价值的微创神经外科技术。随着技术和科学的进步，内镜经蝶手术将逐步完善和发展。
Objective: To explore the techniques and methods of endoscopic transnasal transsphenoid surgery for pituitary adenoma.Method: We treated 678 cases with pituitary adenoma by endoscopic transsphenoidal surgery between May 2000 and May 2006. All cases were operated through a transnasal transsphenoid approach between the nasal septum and middle nasal concha, first to enlarged sphenoid ostium and opened sellar floor with a high-speed drill and then removed the tumor step by step. Sixty-two percent of cases (420 cases) got 6-24 months of follow-up.Results: Among the 678 pituitary adenomas, tumor removal was total in 543 (80.1%), subtotal in 118 (17.4%) and partial in 17 (2.5%). Ninety-eight percent (643 of 655 cases) obtained an improvement in clinical symptoms at some extent after the operation. Post-operative complication (including subarachnoid hemorrhage, nasal cavity bleed, nostril infection, nasal wing deformation and cerebrospinal fluid nasal leakage) occurred in 21 patients (3%). Among the 420 follow-up patients, tumor in four cases recurred 2 years after the first operation.Conclusion: Endoscopic transsphenoidal surgery of pituitary adenomas is a valuable microinvasive neurosurgery technique of minimal invasiveness, being effective and safe, yet requiring simple manipulation. With technological and scientific advancements, endoscopic transsphenoidal surgery will improve and develop step by step.