经单鼻孔-蝶窦内窥镜下切除垂体腺瘤

Endonasal transsphenoidal endoscopic pituitary surgery

目的 探讨神经内窥镜在垂体腺瘤切除术中的应用。方法 用神经内窥镜经单鼻孔 -蝶窦切除垂体腺瘤 2 6例 ,其中泌乳素腺瘤 7例 ,生长激素腺瘤 4例 ,Cushing综合征 3例 ,无功能性腺瘤 12例。结果 内窥镜下全切除肿瘤 2 2例 ,近全切除 4例 ,视力、视野均较术前改善 ;术后 9例内分泌化验恢复正常 ,5例随访激素水平下降 ;2例术后出现一过性脑脊液鼻漏 ,1例术后出现尿崩。结论 经单鼻孔 -蝶窦内窥镜下切除垂体腺瘤 ,创伤小、并发症少、病人恢复快、疗效可靠。

Objective To investigate the application of neuroendoscope in the pituitary surgery.Methods 26 patients with pituitary adenomas were surgical treated through a nostril using rigid endoscopes. 14 patients had hormone-secreting adenomas(7 with prolactinomas, 4 with grouth hormone-secreting adenomas and 3 with Cushing's disease), 12 patients had nonsecreting adenomas.Results 22 underwent total resection and 4 subtotal resection, rapid improvement of vision was noted postoperatively. Among the 14 patients with ho rmone-secreting adenomas, 9 cases got recovery on hormone levels, 5 improved clinically with elevated serum hormone levels with follow-up. 2 patients developed postoperative CSF leakage and 1 patient developed transient diabetes insipidus.Conclusion Endoscopic neurosurgery to treat pituitary adenomas can reduce the trauma of operation , decrease complications, and offer reliable effect.