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目的总结神经内镜辅助经眶上锁孔入路显微手术切除大、巨型垂体腺瘤的经验及体会。方法对我院2001年2月～2006年10月收治的lO例大、巨型垂体腺瘤患者行神经内镜辅助经眶上锁孔入路显微手术切除术。结果肿瘤全切除3例,次全切除4例,大部切除3例。术后无死亡,无严重的手术并发症。术后随访6个月～5年,原有症状均有所改善。9例视力受损病人中改善8例。6例激素水平异常增高病人中降至正常4例。2例次全切除的患者术后接受γ刀治疗,大部切除3例中1例再次经鼻蝶窦内镜手术全切除了肿瘤,另一例行普通放疗控制症状。所有病例随访期间均未发现有明显复发迹象。结论神经内镜辅助经眶上锁孔入路显微手术切除大、巨型垂体腺瘤损伤小、疗效满意。
Objective To summarize the experience and experience of endoscopic assisted endoscopic removal of large and giant pituitary adenomas by supraorbital keyhole approach. Methods A total of 10 cases of large and giant pituitary adenomas admitted to our hospital from February 2001 to October 2006 underwent endoscopic neurosurgical assisted microsurgical resection via supraorbital keyhole approach. Results Total resection in 3 cases, subtotal resection in 4 cases, most of the resection in 3 cases. No death after surgery, no serious complications. Follow-up 6 months to 5 years after surgery, the original symptoms were improved. 9 cases of visually impaired patients improved in 8 cases. 6 patients with abnormally elevated hormone levels decreased to normal in 4 cases. Two subtotal patients underwent gamma knife surgery. One of the three cases underwent subtotal transsphenoidal surgery for complete resection of the tumor, while the other received routine radiotherapy to control the symptoms. No significant recurrence was found in all cases during follow-up. Conclusion Neuroendoscope assisted by supraorbital keyhole approach microsurgical removal of large, giant pituitary adenoma injury is small, the effect is satisfactory.