内镜经鼻低温等离子射频颅底肿瘤切除术的早期经验

Early experience of radiofrequency ablation-assisted resection of skull base tumor through an endoscopic endonasal approach

目的 对采用内镜经鼻入路低温等离子射频颅底肿瘤切除术的早期经验进行总结,探讨该手术技术的安全性和可行性,并初步评价其治疗效果.方法 2013年9-11月,共10例颅底肿瘤于首都医科大学宣武医院采用等离子射频辅助内镜经鼻入路手术技术完成了肿瘤切除手术.对手术相关要点、肿瘤切除程度、术后并发症及早期治疗效果等进行总结.结果 本组病例的术中出血量为60 ～1 000 ml,中位数出血量为285 ml;手术时间为42 ～150 min,中位数手术时间为95 min;住院时间为14 ～19 d,平均15.7 d.在本组中,全部颅底肿瘤均获得了彻底切除,无新增的颅神经功能障碍出现,无脑脊液鼻漏及颅内感染等并发症.术后随访16～ 18个月,无肿瘤复发及与本肿瘤相关的死亡.结论 初步经验表明,低温等离子射频辅助下内镜经鼻入路颅底肿瘤切除技术可以较为安全、可靠地切除部分颅底肿瘤。

Objective To describe the early experience of resecting skull base tumor via a radiofrequency ablation-assisted endoscopic endonasal approach,investigate the safety and feasibility of the technique,and to assess its preliminary treatment outcomes.Methods Ten patients with skull base tumor who were admitted between September and November 2013 were operated on through a radiofrequency ablation-assisted endoscopic endonasal approach in Xuanwu hospital of capital medical university.In this study,the operative technique was described,and the degree of resection,complications and the early clinical outcomes was presented.Results Complete resection was achieved in all patients using this technique.No patient in the series experienced a new neurological deficit,cerebrospinal fluid leak or meningitis after surgery.No recurrence and death related to skull base tumor were found in the follow-up period （16-18 months）.The volume of intraoperative blood loss was 60 to 1 000 ml （medium 285 ml）.The duration of operations was from 42 to 150 min （medium 95 min）.The hospital stay was from 14 to 19 d （average 15.7 d）.Conclusion Our limited experience indicates that this technique is feasible and safe for the complete resection of some skull base tumors in selected cases.