显微镜下与神经内镜下经鼻蝶入路垂体腺瘤切除术对比分析

Comparative analysis of microscopic and neuroendoscopic transsphenoidal approach for pituitary adenoma resection

目的比较显微镜下与神经内镜下经鼻蝶入路垂体瘤切除手术疗效。方法回顾性分析2016年1月~2021年12月接受经鼻蝶入路垂体瘤切除术66例患者的临床资料,其中显微镜下手术31例,神经内镜下手术35例,比较两组手术时间、术中出血量,术后并发症,肿瘤切除率等指标。结果两组患者手术时间、术中出血量比较,差异有统计学意义(P<0.05),内镜组的肿瘤切除率高于显微镜组,但差异无统计学意义(P>0.05)。两组患者术后脑脊液漏、垂体功能低下、视力改善、术后高血糖等并发症比较,差异无统计学意义(P>0.05)。结论神经内镜下经鼻蝶入路垂体瘤切除术与显微镜手术相比疗效相当,但内镜手术具有视野好、照明优、全切率高等优点,适宜广泛应用。

Objective To compare the efficacy of microscopic versus neuroendoscopic transsphenoidal approach pituitary tumor resection surgery.Methods Sixty-six patients who underwent transsphenoidal approach pituitary tumor resection from January 2016 to December 2021,including thirty one cases under microscopic surgery and thirty five cases under neuroendoscopic surgery,were compared in terms of operative time,intraoperative bleeding,postoperative complications,and tumor resection rate between the two groups.Results There was a significant difference between the two groups in the comparison of intraoperative bleeding in operation time(P<0.05),and the tumor resection rate in the endoscopic group was higher than that in the microscopic group,but it was not statistically significant.There was no statistical difference between the two groups in terms of postoperative complications such as cerebrospinal fluid leakage,hypopituitarism,visual acuity improvement,and postoperative hyperglycemia(P>0.05).Conclusion Neuroendoscopic transsphenoidal approach pituitary tumor resection has comparable efficacy compared with microscopic surgery,but endoscopic surgery has the advantages of good visual field,superior illumination,and high total resection rate,and is suitable for wide application.