经眉弓眶上锁孔入路在垂体腺瘤切除术中的应用

Application of the supraorbital key-hole approach for resection of pituitary adenomas

目的总结经眉弓锁孔入路治疗的70例垂体腺瘤的方法、疗效及手术经验。方法回顾性分析2009-07—2011-07经眉弓锁孔入路手术切除垂体腺瘤70例患者的临床资料。结果术后3个月复查MRI确认,肿瘤全切56例,次全切除14例。52例功能性腺瘤中26例恢复正常水平,15例较术前下降,11例改变不明显,无死亡病例。结论眉弓锁孔入路是传统额下入路的微创化改进。不仅可达到相同的暴露和控制范围,而且切口小、美观、微创、恢复快、无需拆线。

Objective To summarize the method,effect and operative experience of transorbital keyhole approach microsurgery.Methods Clinical data of 70patients with pituitary adenomas treated through supraorbital key-hole approach from July 2009to July 2011were retrospective analyzed.Results All the patients received MRI review after surgery in three months,tumors were achieved total removal in 56cases,subtotal removal of 14cases,without surgical mortality.In 52cases with endocrine functional adenomas,the hormone levels of 26 cases returned to normal,15 cases dropped,11 cases unchanged.Conclusion The supraorbital approach is an improvement in terms of minimally invasive compared with tranditional subfrontal approach.Its advantages include not only achieving the same exposure and control,but also combining with smaller incision,faster recovery,fewer complication,need no taking out stitches.