内镜经鼻颅底手术的严重并发症:单中心225例回顾性分析

Severe complications of endoscopic endonasal skull base surgeries:A retrospective analysis of 225 cases in a single institute

目的 回顾性分析中日友好医院颅底外科中心近5年的内镜经鼻颅底手术出现的严重并发症。方法 回顾性分析中日友好医院颅底外科中心2016年8月1日~2021年8月1日间接受内镜经鼻颅底手术患者共225例,调阅纳入研究患者的病历和相关影像学资料,随访至2021年12月31日。结果在225例内镜经鼻颅底手术患者中有6例(2.7%)出现严重并发症。其中大血管损伤3例(颈内动脉损伤2例,大脑前动脉损伤1例),爆发性颅内感染1例,颅内多发性肿瘤种植转移1例,颅底重建移植物大面积坏死1例。结论 内镜经鼻颅底手术对于有经验的颅底外科团队而言是安全的,出现严重手术并发症的几率低,严重并发症的处理仍具有挑战性。

OBJECTIVE To analyze the severe complications of endoscopic transnasal skull base surgery in the skull base surgery center of China-Japan Friendship Hospital in recent 5 years.METHODS A total of 225 patients who underwent endoscopic transnasal skull base surgery in the skull base surgery center of China-Japan Friendship Hospital from August 1,2016 to August 1,2021 were retrospectively analyzed.The medical records and relevant imaging data of the patients included in the study were reviewed and followed up to December 31,2021.RESULTSAmong 225 patients undergoing endoscopic transnasal skull base surgery,6 cases(2.7%) had serious complications.Among them,there were 3 cases of major vessel injury(2 cases of internal carotid artery injury and 1 case of anterior cerebral artery injury),1 case of explosive meningitis,1 case of intracranial multiple tumor implantation metastasis and 1 case of large-area necrosis of skull base reconstruction graft.CONCLUSION Endoscopic endonasal skull base surgery is safe for an experienced skull base surgery team with a low probability of severe surgical complications.The management of severe complications remains challenging.