Abe Takumi
Department of Neurosurgery, Showa University School of Medicine, 5-8 Hatanodai 1, Shinagawa-ku, Tokyo 142-8666, Japan.
Biomed Pharmacother. 2002;56 Suppl 1:171s-177s. doi: 10.1016/s0753-3322(02)00210-x.
A micro-pressure-suction-irrigation system (MPSIS) is a surgical device that cleans the operative field of blood and tumor tissues with one-hand manipulation, dissects tumor tissue with its rapid flow, and removes debris by suction without injury to the normal tissue structures. Since 1997, good transnasal surgical results for pituitary adenomas have been achieved in Japan using this system. However, the surgical results for large, fibrous pituitary adenomas were unfavorable. Ultrasonic surgical aspirators with needle-type probes and an electromagnetic field system, all recently developed in Japan, are improving the results of direct transnasal surgery on pituitary adenomas. The MPSIS effectively dissects typical adenoma tissue with rapid irrigation and removes it by suction. A tumor in the cavernous sinus was removed by this system under direct vision in combination with pituitary mirrors. Fibrous adenomas were resected using ultrasonic surgical aspirators with needle-type probes. Thick mucosa and a firm tumor were vaporized with an electromagnetic field system. The sellar floor was reconstructed with combined ceramics, used in cases requiring additional surgery or drainage of cerebrospinal fluid leakage during surgery. Direct transnasal surgery with these devices was performed to remove 143 pituitary adenomas. Most of these pituitary adenomas could be selectively removed except for those lesions with extensive cavernous sinus invasion. There was no surgical morbidity or mortality. With the advancement of surgical technique and the development of surgical devices, most pituitary adenomas, even those that are fibrous or firm, can be removed via the transnasal route.
微压吸引冲洗系统（MPSIS）是一种外科手术器械，它通过单手操作来清理手术视野中的血液和肿瘤组织，利用其快速流动来分离肿瘤组织，并通过吸引清除碎屑，而不会损伤正常组织结构。自1997年以来，日本使用该系统在垂体腺瘤的经鼻手术中取得了良好的效果。然而，对于大型纤维性垂体腺瘤的手术效果并不理想。最近在日本研发的带有针型探头的超声手术吸引器和电磁场系统，正在改善垂体腺瘤直接经鼻手术的效果。MPSIS通过快速冲洗有效地分离典型腺瘤组织，并通过吸引将其清除。在直视下，结合垂体镜，使用该系统切除了海绵窦内的肿瘤。使用带有针型探头的超声手术吸引器切除纤维腺瘤。使用电磁场系统汽化增厚的黏膜和质地坚硬的肿瘤。在需要额外手术或在手术期间引流脑脊液漏的情况下，使用陶瓷复合材料重建鞍底。使用这些器械进行直接经鼻手术，切除了143例垂体腺瘤。除了那些侵犯海绵窦范围广泛的病变外，大多数垂体腺瘤都可以被选择性切除。没有手术相关的发病率或死亡率。随着手术技术的进步和手术器械的发展，大多数垂体腺瘤，即使是纤维性或质地坚硬的，都可以通过经鼻途径切除。
