鞍区肿瘤的锁孔入路外科治疗

Keyhole approach surgery for treatment tumors in sellar region

目的探讨利用锁孔入路治疗鞍区肿瘤的临床效果和意义。方法对42例采用锁孔入路和40例传统入路治疗的鞍区肿瘤病例的临床结果进行前瞻性对照研究。结果锁孔入路与传统入路相比,肿瘤切除程度、主要术后并发症和术后复发率比较,差异均无显著性(P>0.05)。但是锁孔入路患者术中出血量、输血率、术后平均住院天数和术后皮下积液发生率均明显低于对照组(P<0.01)。结论锁孔入路治疗鞍区肿瘤符合微创手术治疗的原则,是治疗颅咽管瘤等鞍区病变可行的微创手术方法。

Objective To evaluate the clinical effect and significance of keyhole approach surgery in the treatment of tumors in the sellar region. Methods 42 patients with tumors in the sellar region were operated via keyhole approach were studied prospectively with 40 patients with same lesions but treated via a conventional subfrontal approach. Results No significant difference was found in tumor resection degrees, main postoperative complications and recurrence rates between the conventional subfrontal approach and the keyhole approach. However, the keyhole approach required a much shorter hospitalization duration and less blood transfusion volume, causing less surgical bleeding and subcutaneous liquid than those of conventional approach （ P 〈 0.01 ）. Conclusion The Keyhole approach for treating tumors in the sellar region conforms to minimally invasive surgery principle, so it is feasible for treating lesions in the sellar region such as craniopharyngioma.