神经导航及神经内镜下切除垂体腺瘤的疗效观察

Clinical efficacy of neuroendoscopic resection of pituitary adenomas via endonasal transspheniodal approach under neuronavigation: report of 59 cases

目的探讨神经内镜结合神经导航手术操作系统(Neuro Navigation)经鼻碟入路垂体瘤切除术中的应用。方法 MRI扫描后,将资料输入神经导航系统,在神经内镜的辅助下,精确性定位,直达肿瘤部位。结果 59例患者中肿瘤全部切除54例,次全切除5例,术后所有患者症状均有不同程度的改善,无严重并发症。所有患者在经鼻蝶入路过程中均无明显偏差,平均系统误差1. 5 mm。所有手术入路设计在术前完成,尽量避开功能区,使病灶完整或最大限度切除。结论神经导航系统与神经内镜结合辅助鼻碟入路垂体瘤的切除术提高了准确性、可靠性、切除病灶彻底、副损伤小,提高手术的成功率,减少手术并发症。

Objective The application of neuronavigation and neuroendoscope in the resection of pituitary adenomas by endonasal transspheniodal approaches was investigated. Methods MRI data were transported to the neuronavigation system. Under the endoscope,the tumor was localized accurately and approached successfully.Results Complete resection was achieved in 54 patients and subtotal resection was achieved in 5. The symptoms were relieved or improved,and no severe complications developed. The tumor site was reached smoothly and accurately under the neuronavigation and neuroendoscope by transsphenoidal approach. The mean margin of error was1. 5 mm. Conclusion The application neuronavigation and neuroendoscope in the resection of pituitary adenomas by endonasal transspheniodal approach is helpful to improve the accuracy and to reduce the complications after surgery.