Jarrahy R, Berci G, Shahinian H K
Division of Skull Base Surgery, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
Arch Otolaryngol Head Neck Surg. 2000 Dec;126(12):1487-90. doi: 10.1001/archotol.126.12.1487.
To obtain objective evidence that the use of endoscopy in the surgical management of pituitary tumors improves intraoperative visualization and significantly impacts operative outcomes.
Case series of pituitary adenomas treated surgically by endoscope-assisted microscopic resection.
University-affiliated tertiary care medical center.
Consecutive sample of 9 patients referred for surgical management of pituitary adenoma.
Each patient underwent transseptal transsphenoidal microscopic tumor resection. The procedure was modified by the use of intrasellar endoscopy as an adjunctive imaging modality. Following complete microscopic resection of tumor, rigid 0 degrees and 30 degrees 4.0-mm endoscopes were used to conduct a final survey of the sellar and parasellar spaces. Residual tumor fragments identified during this endoscopic examination were removed.
Endoscopes were thought to have a significant impact on surgical therapy in cases where residual tumor that was not detected microscopically was identified and removed during endoscopic examination. Analysis of each case included correlation between intraoperative findings and retrospective review of dictated operative reports and intraoperative videotape.
Three of the patients with macroadenoma (33% of total, 43% of macroadenoma cases) had tumor fragments that were only identified and removed endoscopically.
Endoscopy provides distinct advantages over microscopy in imaging intrasellar and parasellar structures during pituitary tumor resection. These data support the numerous anecdotal accounts of the usefulness of pituitary endoscopy and are consistent with the small amount of objective evidence offered on the subject. Arch Otolaryngol Head Neck Surg. 2000;126:1487-1490
获取客观证据，证明在内镜辅助下进行垂体瘤手术可改善术中视野并显著影响手术效果。
通过内镜辅助显微切除术治疗垂体腺瘤的病例系列研究。
大学附属三级医疗中心。
连续选取9例因垂体腺瘤接受手术治疗的患者。
每位患者均接受经鼻中隔经蝶窦显微肿瘤切除术。术中使用鞍内内镜作为辅助成像手段对手术进行改良。在肿瘤完全显微切除后，使用硬性0度和30度4.0毫米内镜对鞍内和鞍旁间隙进行最终检查。在内镜检查中发现的残留肿瘤碎片予以清除。
如果在内镜检查中发现并清除了显微镜下未检测到的残留肿瘤，则认为内镜对手术治疗有显著影响。对每个病例的分析包括术中发现与手术记录和术中录像的回顾性相关性分析。
3例大腺瘤患者（占总数的33%，占大腺瘤病例的43%）的肿瘤碎片仅在内镜检查中被发现并清除。
在内镜辅助下进行垂体瘤切除术中，内镜在鞍内和鞍旁结构成像方面比显微镜具有明显优势。这些数据支持了众多关于垂体内镜有用性的传闻报道，并且与该主题提供的少量客观证据一致。《耳鼻喉科头颈外科文献》。2000年；126:1487 - 1490
