经鼻蝶入路神经内镜下垂体腺瘤切除术进展

Research Progress on Endoscopic Endonasal Transsphenoidal Surgery for Pituitary Adenomas

目的：探讨神经内镜下经鼻蝶人路在垂体腺瘤切除术中的应用。方法：在Pubmed、中国知网等数据库查阅有关经鼻蝶入路神经内镜下垂体腺瘤切除术研究的文献，汇总分析。结果：经鼻蝶入路神经内镜下垂体腺瘤切除术分为标准入路和扩大入路。通过扩大入路，可以切除侵犯海绵窦、鞍上和斜坡的垂体腺瘤。经鼻蝶入路神经内镜垂体腺瘤切除术的并发症主要有脑脊液鼻漏、尿崩和出血等。结论：经鼻蝶入路神经内镜下垂体腺瘤切除术具有损伤小、暴露充分、肿瘤全切率高及术后并发症少等优点，是垂体腺瘤切除的理想术式。

Objective：To discuss the clinic application of endoscopic endonasal transsphenoidal ap- proach in the treatment of pituitary adenomas. Methods：To look into such literatures related to research of en- doscopic endonasal transsphenoidal surgery for pituitary adenomas in database PubMed, CNKI and so on, sum- marize and analyze the results. Results：The approaches of endoscopic endonasal tran - ssphenoidal surgery for pituitary adenomas includes standard transsphenoidal approach and extended transsphenoidal approach. Pituita- ry adenomas invading suprasellar, cavernous sinus （CS）, and clivus can be removed through extended transs- phenoidal approach. The complications of endoscopic endonasal transsphenoidal surgery for pituitary adenomas include diabetes insipidus, cerebrospinal fluid leaks and hemorrhage. Conclusions：Endoscopic endonasal trans- sphenoidal approach provides an minimally invasive surgery for pituitary adenomas, and can expose fully. This approach is safe and has higher rates of gross total resection with fewer complications, so it is widely accepted as an ideal method for most pituitary adenomas.