神经内镜下经鼻蝶窦切除垂体瘤

Endoscopic endonasal transsphenoid surgery of pituitary adenoma

目的探讨神经内镜下经鼻蝶窦入路切除垂体瘤的手术方法和技巧。方法回顾分析2008年5月至2012年10月南京医科大学第一附属医院收治的神经内镜下经鼻蝶窦入路切除垂体瘤103例。结果神经内镜下经鼻蝶窦入路全切垂体瘤97例(94.2%)。术后平均住院天数5.5天,无手术死亡病例,2例术后脑脊液漏,1例经再行手术修补,1例经腰穿置管平卧治疗后自愈。结论对蝶窦气化较完全的患者,经鼻蝶窦手术入路创伤小、安全有效。

Objective To explore the surgical treatment strategies of pituitary adenomas by endoscopic en- donasal transsphenoid surgery. Methods The clinical data of 103 cases of pituitary adenomas from May 2008 to October 2012 were retrospective analyzed for evaluation of surgical treatment through endoscopic endonasal transsphenoid surgery. Results 97 pituitary adcnomas （ accounts for 94.2% ） were totally removed through en- doscopic endonasal transsphenoid surgery. The average postoperative hospital stay was 5. 5 days, with no deaths. 2 patients had cerebral spinal fluid leak, and 1 patient was recovered by repair operation, 1 patient was recovered by lumbar puncture catheterization. Conclusions Endoscopic endonasal transsphenoid surgery ap- pears to be a safe surgical option for pituitary adenoma with complete pneumatisation of sphenoid sinus in most.