经鼻蝶窦入路切除垂体腺瘤

Removal of Pituitary Adenoma by Microsurgery through Transnaso-sphenoidal Approach

目的介绍经鼻蝶窦入路手术治疗垂体腺瘤的方法改进及其优缺点。方法我科1999年1月至2006年1月经鼻蝶窦入路手术切除垂体腺瘤108例,其中经鼻-中隔前-蝶窦16例,鼻-软骨后中隔(中部)-蝶窦72例,直接经蝶20例,所有病人均经CT或MRI确诊,术中辅以显微镜或内窥镜行肿瘤切除。结果108例垂体腺瘤中,全切85例,次全切22例,大部分切除1例。术后无严重手术并发症。与同期经唇下-中隔-蝶窦入路病人比较,经此入路手术治疗的病人住院天数短,费用低。结论经鼻蝶窦入路切除垂体腺瘤是一种安全有效的微侵袭手术方法。

Objective To introduce the advantage and shortcoming of transnaso-sphenoidal microsurgery for pituitary adenomas. Methods The pituitary adenomas were removed by microsurgery throgh transnaso-sphenoidal approach in 108 patients from January 1999 to January 2006. The preoperative diagnosis was made by CT or MRI scan. The operations were performed under microscope or endoscope. Of 108 patients with pituitary adenomas, 16 underwent microsurgery through endonasal unilateral-septal transsphenoidal approach, 72 through transnaso-vestibulo-sphenoidal approach and 20 through direct transsphenoidal approach. Results Of 108 patients with pituitary adenomas, 85 received total removal of tumor, 22 subtotal and 1 greatly part. There were not severe operative complication in all the patients. The hospitalization cost is lower in the patients with pituitary adenomas undergoing microsurgery through transnasosphenoidal approach than that via sublabio-septo-sphenoidal approach. Conclusion The microsurgery through transnaso-sphenoidal approach is a safe and effective method to remove pituitary adenomas.