神经内镜下与显微镜下经鼻蝶入路手术切除垂体腺瘤的疗效对比分析

Resection of pituitary adenomas by endoscopic and microscopic surgery via transnasal transsphenoidal approach: a comparative analysis

目的探讨神经内镜下与显微镜下经鼻蝶入路手术切除垂体腺瘤的疗效。方法 2010年1月至2015年10月经鼻蝶入路手术切除垂体腺瘤319例,其中神经内镜下手术127例(神经内镜组),显微镜下手术192例(显微镜组)。结果神经内镜组和显微镜组手术时间、住院时间和肿瘤全切率均无统计学差异(P>0.05),但是神经内镜组鼻中隔缺损率、复发率和术后尿崩发生率(分别为20.47%、4.72%和8.66%)均明显低于显微镜组(分别为36.98%、13.02%和27.60%;P<0.05)。结论神经内镜与显微镜下经鼻蝶入路手术切除垂体腺瘤的疗效相当,但神经内镜下手术并发症发生率较低。

Objective To compare the curative effect of endoscopic surgery via transnasal transsphenoidal approach on pituitary adenomas with that of transnasal transsphenoidal microsurgery on them.MethodsThe clinical data of 319 patients with pituitary adenomas, of whom, 127 underwent endoscopic surgery via transnasal transsphenoidal approach and 192 underwent microsurgery via transnasal transsphenoidal approach from January, 2010 to October, 2015 were analyzed retrospectively.Results The pituitary adenomaswere definitely diagnosed by pathological examination. The rates of nasal septum defect, diabetes insipidus occurrence and tumorsrecurrence were 20.47%, 8.66% and 4.72% respectively in the endoscopic group, and they were 36.98%, 27.60% and 13.02% respec-tively in the microscopic group. There were significant differences in all the above-mentioned rates between both the groups（P〉0.05）.There were insignificant differences in the rates of the other complications occurrence and curative effect between the two groups（P〈0.05）.Conclusions The endoscopic surgery via transnasal transsphenoidal approach is similar to the microscopic surgery via transnasal transsphenoidal in the curative effects on the pituitary adenomas. But the endoscopic surgery via transnasal transsphenoidal approach has advantages including the lower rates of nasal septum defect and diabetes insipidus occurrence and tumorous recurrence compared to the microsurgery via the same approach in the patients with pituitary adenomas.