神经内镜下经鼻-蝶窦入路手术治疗大型垂体腺瘤36例

Treatment of 36 Cases with Giant Pituitary Adenoma Via Endoscopic Transsphenoidal Approach

目的探讨神经内镜下经鼻-蝶窦入路手术治疗大型垂体腺瘤的手术技巧。方法回顾性分析2004年6月至2009年2月间治疗的大型垂体腺瘤患者36例,手术采用神经内镜下经鼻-蝶窦入路肿瘤切除术。结果肿瘤全切除24例(66.7%),次全切除10例(27.8%),部分切除2例(5.6%)。28例患者随访6个月～3年,症状和内分泌学指标有所改善,肿瘤复发2例。结论神经内镜下经鼻-蝶窦入路手术是治疗大型垂体腺瘤微创、安全、有效的方法。

Objective To discuss the operative techniques of endoscopic transsphenoidal surgery for resection of giant pituitary adenoma.Methods From June 2004 to February 2009,36 cases of giant pituitary adenoma were treated by endoscopic transsphenoidal surgery.Results The tumor removal was total in 24（66.7%） cases,subtotal in 10（27.8%）,and partial in 2（5.6%）.Twenty eight patients got a follow-up of 6～36 months.All patients achieved an improvement in clinical symptom and endocrine status after the operation.Tumor recurrence was found in 2 cases within follow-up period.Conclusion The endoscopic transsphenoidal surgery is minimally invasive and safe and effective in treatment of giant pituitary adenoma.