神经内镜辅助下经鼻蝶入路治疗鞍区肿瘤

Transsphenoidal surgery assisted by neuroendoscopy for tumor in the sellar region

目的探讨神经内镜辅助下经鼻蝶入路切除鞍区肿瘤的方法和优势。方法回顾性分析30例鞍区肿瘤病人的临床资料,垂体腺瘤26例（其中无功能垂体腺瘤6例、泌乳素瘤16例、垂体生长激素腺瘤4例）,拉克囊肿1例,胆脂瘤1例,脑膜瘤1例,颅咽管瘤1例。采用神经内镜辅助下经鼻蝶入路手术切除肿瘤。结果肿瘤全切27例,部分切除3例。术后3例发生脑脊液鼻漏,经腰大池持续引流后痊愈。无死亡病例。随访3～6个月,病人恢复良好。结论在神经内镜辅助下经鼻蝶入路治疗鞍区肿瘤,较单纯的显微镜手术治疗创伤更小,肿瘤全切率更高。

Objective To investigate the methods and advantages of transsphenoidal surgery assisted by neuroendoscopy for tumor in the sellar region.Methods Clinical data of 30 patients with sellar region tumor were analyzed retrospectively,including 6 nonfunctioning pituitary adenomas,16 prolactinomas,4 growth hormone-secreting pituitary adenomas,1 Rathke＇s cyst,1 cholesteatoma,1 meningioma and 1 craniopharyngioma.Transsphenoidal surgery assisted by neuroendoscopy was performed in all the patients.Results Total tumor removal was achieved in 27 patients and partial removal in 3.Cerebrospinal fluid leakage occurred in 3 patients who recovered well after continued lumbar drainage.No patient died.Conclusion Compared with simple microsurgery,transsphenoidal surgery assisted by neuroendoscopy for tumor in sellar region has less injury and higher total resection rate.