鞍区肿瘤显微手术切除19例临床体会

Clinical Experiences of Microsurgery Technique for Sellar Tumors(19 Cases Report)

目的总结鞍区肿瘤手术的显微操作技术与经验体会。方法采用翼点、额下、经蝶等手术入路对19例鞍区肿瘤病人施行显微手术,其中垂体腺瘤11例,颅咽管瘤6例,Rathke囊肿2例。结果本组全切12例,近全切2例,大部切除5例。术后出现一过性尿崩3例,电解质紊乱4例,颅神经损伤2例,均经对症治疗后好转。19例随访6月～3年,均恢复正常工作及生活,MRI复查未见复发。结论正确的手术入路选择和精巧的显微手术技术,是提高鞍区肿瘤全切除率、降低死亡率和术后并发症的关键。

Objective To summarize the microsurgery techniques and experiences of the sellar tumors. Method The microsurgery was undergone through the wing point,the sub-forehead,the sphenoid sinus and other surgical approaches in 19 cases of sellar tumor,including pituitary adenoma in 11 cases,craniopharyngioma in 6 cases and Rathke cyst in 2 cases.Results The sellar tumors were cut totally in 12 cases,subtotally in 2 cases and great partially in 5 cases.No death or serious complications.In the 19 cases who were followed up for 6～36 months,all cases resumed normal work and life.Conclusion It is the key to improve the sellar tumor resection rates and to reduce the mortality and postoperative complications of choosing the correct surgical approaches and sophisticated microsurgical techniques.