[1]蔡瑜,赵卫国,沈建康,等.垂体大腺瘤经蝶显微手术84例[J].中国微创外科杂志,2005,05(8):664-665.
　Cai Yu,Zhao Weiguo,Shen Jiankang,et al.Transsphenoidal microsurgery for pituitary macroadenomas[J].Chinese Journal of Minimally Invasive Surgery,2005,05(8):664-665.
点击复制

垂体大腺瘤经蝶显微手术84例()
分享到：

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
05
期数:
2005年8期
页码:
664-665
栏目:
出版日期:
2005-08-31

文章信息/Info

Title:
Transsphenoidal microsurgery for pituitary macroadenomas
作者:
蔡瑜; 赵卫国; 沈建康; 卞留贯; 成侃　
上海第二医科大学附属瑞金医院神经外科,上海,200025
Author(s):
Cai Yu;  Zhao Weiguo;  Shen Jiankang;  et al.
Department of Neurosurgery, Ruijin Hospital of Shanghai Second MedicalUniversity, Shanghai200025, China
关键词:
垂体大腺瘤; 经蝶入路; 显微外科手术
Keywords:
Pituitarymacroadenoma; 　Transsphenoidal approach; 　Microsurgery
分类号:
R651.1+3?
文献标志码:
A
摘要:
目的总结经蝶入路治疗垂体大腺瘤的手术经验. 方法 1999年1月～2003年12月采用经蝶窦入路显微手术治疗垂体大腺瘤84例,其中经右侧鼻腔-鼻中隔-蝶窦入路74例,经唇下-鼻中隔-蝶窦入路10例. 结果手术无死亡.术后MRI复查显示,近全切除(>95%)56例(66.7%),次全切除(>85%)18例(21.4%),部分切除(<50%)10例(11.9%).4例部分切除,术后1周再次行经额或经翼点入路手术切除肿瘤.65例随访6～48个月,平均24个月,除3例复发接受放射治疗外,余62例均恢复良好. 结论经蝶显微手术治疗垂体大腺瘤是一种安全、有效的手术技术,术后放疗可以控制肿瘤复发.
Abstract:
Objective　To summarize the experience of transsphenoidalmicrosurgery forpituitarymacroadenomas.　M ethods A total of 84 patients with pituitary macroadenoams were treated with transsphenoidalmicrosurgery from January 1999 to December 2003. Operations were performed via either transnasal- transseptal- transsphenoidal (74 patients) or sublabial- transseptal- transsphenoidal (10 patients) approach with microsurgical technique.　Results　No surgery- related deaths were observed. PostoperativeMRI examinations revealed a gross total resection (>95% ) was achieved in 56 patients (66·7% ), a subtotal resection (>85% ) in 18 patients (21·4% ) and a partial resection (<50% ) in 10 (11·9% ). Of 4 patientswith partial resection, tumors were removed 1 week after surgery via transfrontal or transpterygoid route. Follow-up observationswere carried out for6~48 months (mean, 24 months) in 64 patients. Except3 patients had a tumor recurrence and underwentan additional radiotherapy, the restof62 patients had recovered uneventfully.　Conclusions　Transsphenoidalmicrosurgery is a safe and effective option for the treatment of pituitarymacroadenomas. Postoperative additional radiotherapy is necessary for preventing recurrence.

参考文献/References:

[1]Zhang X, Li AM, Yi SY, et al. Transsphenoidal microsurgical removal of large pituitary adenomas. Chin Med J (Eng), 1998, 111(1): 963-967.
[2]Kawamata T, Iseki H, Ishizaki R, et al. Minimally invasive endoscope-assisted endonasal trans-sphenoidal microsurgery for pituitary tumors: experience with 215 cases comparing with sublabial trans-sphenoidal approach. Neurol Res, 2002, 24(3): 259-265.
[3]邬祖良, 谭启富, 史继新, 等. 垂体腺瘤经蝶窦显微手术432例. 中华外科杂志, 1999, 37(6): 350-352.
[4]Alleyne CH, Barrow DL, Oyesiku NM, et al. Combined transsphenoidal and peterional craniotomy approach to giant pituitary tumors. Surg Neurol, 2002, 57(6): 380-390.
[5]Garibi J, PomposoI, Villar G, et al. Giant pituitary adenomas: clinical characteristics and surgical results. Br J Neurosurg, 2002, 16(2): 133-139.
[6]Jane JA, Thapar K, Kaptain GJ, et al. Pituitary surgery: transsphenoidal approach. Neurosurg, 2002, 51(2): 435-444.
[7]Ciric I, Ragin A, Baumgartner C, et al. Complications of transsphenoidal surgery: results of a national survery, review of th literature, and personal experience. Neurosurg, 1997, 40(2):225-237.

更新日期/Last Update: 2014-04-10