内镜下经鼻蝶入路垂体腺瘤手术及并发症

Endoscopic endonasal transsphenoidal approach for pituitary adenomas and surgical complications

目的 探讨内镜下经鼻蝶入路垂体腺瘤手术疗效及并发症的防治。方法 回顾分析2001年7月至2003年12月31例内镜下经单鼻孔垂体腺瘤切除手术并具备半年以上随访的病例。结果 肿瘤全切除17例,大部分切除9例,部分切除5例。术后2例有一过性脑脊液鼻漏,2例出现短暂尿崩,1例出现蛛网膜下腔出血,经腰穿适量放液,对症治疗,病人分别于手术后2周、3周完全恢复。结论 内镜下经鼻蝶入路对各型及开颅术后复发或残留性垂体腺瘤切除均可选择。

Objective To discuss the efficacy of craniotomy via endoscopic endonasal transsphenoidal approach for removing pituitary adenomas, and the prevention and treatment of postsurgical complications, including the remnants or relapses. Methods 31 cases accepting the craniotomy through endonasal transsphenoidal approach from July 2001 to December 2003 were analyzed retrospectively. All the cases were followed up over half a year. Results The total removal was achieved in 17 cases, most removal in 9 and partial in 5. 2 cases developed temporary cerebrospinal rhinorrhea, 2 cases with transient diabetes insipidus and 1 with subarachnoid hemorrhage. Some related measures, such as translumbar puncture for fluid release, were adopted so that all patients get well recovered after 2 or 3 weeks. Conclusion Endoscopic endonasal transsphenoidal approach can be the option for the removal of all sorts of pituitary adenomas, even recurrent or residual ones.