经鼻蝶入路神经内镜手术联合眶上外侧入路显微手术治疗大型垂体腺瘤

Transnasal endoscopic surgery combined with microsurgery via supraorbital lateral approach for patients with large pituitary adenoma

目的探讨经鼻蝶入路神经内镜手术同期联合眶上外侧入路显微手术治疗大型垂体腺瘤的方法及效果。方法回顾性分析2020年5月至2022年4月采用经鼻蝶入路神经内镜手术同期联合眶上外侧入路显微手术切除的5例大型垂体腺瘤的临床资料。结果术后病理显示生长激素腺瘤2例、无功能腺瘤3例。术后未出现颅内感染、脑脊液漏。1例失访;其余4例肿瘤均切除完全,术后3~6月复查MRI未及复发,激素水平均恢复正常,无需药物替代治疗。结论经鼻蝶入路神经内镜手术同期联合眶上外侧入路显微手术治疗大型垂体腺瘤的优势明显,肿瘤全切除率高,创伤较小,疗效满意。

Objective To explore the surgical methods and efficacy of transnasal endoscopic surgery(TES)combined with microsurgery via supraorbital lateral approach for patients with large pituitary adenoma.Methods A retrospective analysis was performed on the clinical data of 5 patients with large pituitary adenoma who underwent TES combined with microsurgery via a supraorbital lateral approach from May 2020 to April 2022.Results The postoperative pathological examination showed growth hormone adenoma in 2 patients and nonfunctional adenoma in 3.One patient was lost to follow-up,and the follow-up(3~6 months)of the other 4 patients showed complete removal of the tumor and no relapse.The serum hormone levels returned to normal without drug replacement treatment.Conclusions TES combined with microsurgery via supraorbital lateral approach is a safe and effective method for the treatment of patients with large pituitary adenoma.