多模态神经导航技术指导内镜垂体瘤手术在神经外科专培学员临床教学中的应用

Application of multimodal neuronavigation guided endoscopic surgery for pituitary adenoma in clinical education of special trainee in neurosurgical department

目的探索多模态神经导航技术在内镜垂体瘤手术临床教学中的应用价值。方法回顾性分析2019年10月—2021年1月本院收治的40例内镜经鼻垂体瘤切除术患者的临床资料,其中行多模态神经导航技术引导下内镜经鼻蝶垂体瘤切除术者设为导航手术组(20例),行常规内镜经鼻蝶垂体瘤切除术作为常规手术组(20例)。评估专培学员对解剖结果判断准确率,比较两组打开鞍底硬膜手术时间。结果导航手术组肿瘤最大径为(2.32±0.52)cm,常规手术组肿瘤最大径为(2.28±0.52)cm,差异无统计学意义(P=0.810)。导航手术组中,以多模态神经导航为标准,年轻术者对解剖结构判断准确的病例有14例,准确率为70%。导航手术组打开鞍底硬膜的手术时间为(32.6±6.2)min,常规手术组打开鞍底硬膜的手术时间为(39.1±5.7)min,差异有统计学意义(P<0.05)。结论借助于多模态神经导航技术,可提高专培学员对解剖结构判断的准确率,缩短肿瘤显露的时间,提高神经外科专培学员临床教学效率。

Objective To investigate the value of multimodal neuronavigation technology in clinical education of endoscopic surgery for pituitary adenoma.Methods The clinical data of 40 patients who underwent the resection of pituitary adenoma through endoscopic transsphenoidal approach during the period from October 2019 to January 2021 were retrospectively analyzed.The 20 cases underwent endoscopic transsphenoidal resection of pituitary adenoma under the guidance of multimodal neuronavigation were enrolled in the navigation group.The other 20 cases underwent conventional endoscopic transsphenoidal resection of pituitary adenoma were enrolled in the routine group.Accuracy of anantomical judgement was evaluated.Surgical time for opening sellar dura was compared between the two groups.Results The maximum diameter of tumor in navigation group was 2.32±0.52 cm,while in the routine group,it was 2.28±0.52cm.There was no statistically difference between the two groups(P=0.810).Among the 20 cases in the navigation group,the anatomic structures of 14 cases were accurately identified by the young neurosurgeon.The accuracy rate was 70%.The operation time of opening the dural of the base of the sella turcica was(32.6±6.2)min in the navigation surgery group and(39.1±5.7)min in the conventional surgery group,and the difference was statistically significant(P<0.05).Conclusions With the guidance of multimodal neuronavigation,the accuracy of anatomical structure judgment by neurosurgical fellow can be improved.The time of tumor exposure can be shorten,and efficiency of clinical teaching can also be improved.