鞍区肿瘤的显微外科治疗(附106例报告)

Treatment of complicated tumors in sellar area with microsurgical techniques: report of 106 cases

目的探讨复杂鞍区肿瘤的显微外科治疗方法。方法分析近4年来通过显微神经外科技术治疗的106例复杂鞍区肿瘤的临床资料。手术采用改良翼点入路,运用显微外科技术从鞍区的各个手术间隙分块切除肿瘤。结果73例垂体腺瘤肿瘤全切59例,大部分切除14例;22例颅咽管瘤全切18例,大部切除4例;11例脑膜瘤全切9例,大部分切除2例。病人术后均神志清楚,6例发生了视神经功能障碍,2例发生了动眼神经功能障碍。结论改良翼点入路是处理复杂鞍区肿瘤的极佳手术径路。熟练掌握显微神经外科技术和熟悉鞍区的各个手术间隙解剖并能在术中充分利用之是完成复杂鞍区肿瘤切除术的关键。

Objective To investigate the methods of treating complicated tumors located in sellar area with microsurgical techniques. Methods The experience on the treatment of 106 patients with complicated tumors in sellar area with microsurgical techniques was analyzed. The operations were performed by a modified transpterional approach, and tumors were removed from spaces in sellar area with microsurgical techniques. Results Among 73 pituitary adenomas, 22 craniopharyngiomas and 11 sellar meningiomas, 59, 18 and 9 were totally removed, respectively. And the others were subtotally removed. All the patients were sober after operation. Functional deficits of optic nerves and oculomotor nerves appeared in 6 and 2 patients respectively. Conclusion This modified transpterional approach is very suitable to remove complicated sellar tumors. Mastering the microsurgical techinques and acquaintanc with the anatomy spaces in sellar area, which can be perfectly utilized intraoperatively, and are the keys to remove complicated tumors in sellar area.