扩大经蝶窦入路切除巨大或侵袭性生长的垂体腺瘤

Extended transsphenoidal approach for resection of giant and invasive pituitary adenomas

目的探讨采用扩大经蝶窦入路切除巨大或侵袭性生长垂体腺瘤的方法。方法病人13例,男性8例,女性5例;平均46.7岁;平均病程6.2年;肿瘤直径为3.0～5.5cm;向前方及额叶底部生长2例,向侧方生长包绕海绵窦6例,向后方斜坡方向生长5例。13例患者均采用扩大经蝶窦入路显微外科切除垂体腺瘤。结果全部切除肿瘤12例,次全切除1例。随诊2个月至4年,肿瘤无复发。结论采用扩大经蝶窦入路切除巨大或不规则鞍外生长垂体腺瘤时,肿瘤显露满意,肿瘤全切除率高,无明显手术并发症。

Objective to explore the new approach for removing the giant and invasive pituitary adenomas. Methods Among the 13 patients, 8 were male and 5 were female. Mean age was 46.7 yrs old and mean history was 6.2 years. The tumor was 3.0-5.5cm in size. Among them, 2 extended to the base of the frontal lobe, 6 extended to surround carverneous sinus, 5 extended to clivus. The extended transsphenoidal approach was used to remove the giant pituitary adenomas in all the patients. Results 12 patients had total resection of pituitary adenomas, and one had subtotal resection of pituitary adenoma. Postoperative follow-up were 2 months to 4 years. No one recurred. Conclusion Using extended transsphenoidal approach for giant pituitary adenoma, the tumor would be satisf actorily approached and completely removed. No severe complications were found.