神经内镜技术在联合入路治疗垂体腺瘤中的应用

Application of neuroendoscopy in treatment of pituitary adenomas through combined approach in staged operations

目的探讨神经内镜技术在分期手术时，采用经蝶窦和开颅联合人路治疗垂体腺瘤中的应用。方法2009年3月至2013年3月天坛医院内镜神经外科专业组采用分期联合入路手术治疗32例垂体腺瘤患者，包括肿瘤残存患者20例，复发患者12例。分期手术中至少有一次为内镜下经鼻蝶窦人路手术。术后影像学检查确定肿瘤切除程度。结果全切17例（53％），次全切4例（13％），大部切除7例（22％），部分切除4例（13％）；其中残存肿瘤的全切率为35％（7／20），复发肿瘤的全切率为83％（10／12）。结论神经内镜技术在分期手术联合入路治疗垂体腺瘤中具有重要应用价值。

Objective To investigate application of neuroendoscopic technology in treatment of pituitaric adenomas in staged operations through combined transsphenoidal and transcranial approach. Methods The records of 32 patients who underwent staged operations through combined approach with neuroendoscopy between March 2009 and March 2013 were retrospectively reviewed. 20 patients are of residual tumors and 12 are of recurrent tumors. Treatment effects are evaluated with image studies. Results Total resection of the tumor was achieved in 17 cases （53%）, subtotal in 4 cases （ 13% ）, most in 7 cases （22%） and partial in 4 cases （ 13% ）. Total resection of the residual tumor was achieved in 7 out of 20 cases （35%）, while that of recurrent tumor in 10 out of 12 cases （83%） Conclusion Neuroendoscopic technology is notable value in treatment for pituitary adenomas with staged operations through combined approach.