内窥镜下经鼻腔蝶窦入路切除巨大垂体腺瘤

Resection of Giant Pituitary Adenomas by Endoscope-assisted Surgery through Transnasal and Transsphenoidal Approach

目的报道内窥镜下经鼻腔蝶窦入路切除巨大垂体腺瘤11例,探讨该手术优缺点、适应症、禁忌症及并发症。方法采用鼻内窥镜,经鼻腔直接开放蝶窦、鞍底,在直视下切除垂体腺瘤。结果11例患者肿瘤均肉眼下全切除,无手术死亡及严重并发症,术后患者视力及视野均有明显好转。结论鼻内窥镜下经鼻腔蝶窦径路切除垂体腺瘤是简便、安全和有效的,适用于蝶窦发育良好的垂体腺瘤切除,值得有条件的医院开展此入路手术。

Objectives To summarize the experience in the resecting giant pituitary adenomas by endoscope-assisted surgery through transnasal and transsphenoidal approach and to explore its merits,demerits,indication,contraindication and complication.Methods The sphenoid sinus and sellar basis were transnasally opened,and the tumors were removed under the nasal endoscope in11patients with giant pituitary adenomas.Results The grossly total excision was achieved in11cases,and death or severe complications did not occurred.The vision and visual field were observably improved in11patients.Conclusions It is a simple,safe and effective method to remove the pituitary adenomas via the transnasal and transsphenoidal approach by endoscope-assisted surgery.The transnasal and transsphenoidal approach is suitable for resection of pituitary adenomas in the patients whose sphenoidal sinus developed well.