Gong Shou-ping, Lü Jian, Song Qian, Yang Qing-yu
Department of Neurosurgery, Second Affiliated Hospital of Xi'an Jiaotong University College of Medicine, Xi'an 710004, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2009 Feb;29(2):305-6.
To investigate the association of microsurgical anatomy and growth of pituitary tumors with the recovery of visual pathway, and describe the intraoperative protection of the pituitary stalk and visual pathway.
A total of 113 patients undergoing pituitary tumor surgery were retrospectively analyzed, including 102 with visual disorder and 106 with pituitary dysfunction with the tumor size ranging from 1.9 to 6.8 cm. All the operations were performed via a transpterygoid approach or transfrontal approach.
Radical resection of the tumors was performed in 86 cases, subtotal resection in 21 cases, and partial resection in 5 cases. After operation, 133 eyes showed vision improvement (77.8%), 29 showed no vision changes (17%) and 9 had deteriorated vision. Two patients died due to hypothalamic disorder and multiple organ failure.
The arachnoid barrier between the pituitary tumor and visual pathway is an important structure for visual pathway protection during operation. Total separation of the tumor from the visual pathway allows total removal of the tumor. The preoperative localization and intraoperative identification of the pituitary stalk are critical for pituitary stalk protection.
探讨垂体瘤的显微外科解剖结构、生长情况与视路恢复的相关性，并描述垂体柄和视路的术中保护。
回顾性分析113例接受垂体瘤手术的患者，其中102例有视力障碍，106例有垂体功能障碍，肿瘤大小为1.9至6.8厘米。所有手术均经翼点入路或经额入路进行。
86例患者肿瘤全切，21例次全切除，5例部分切除。术后133只眼视力改善（77.8%），29只眼视力无变化（17%），9只眼视力恶化。2例患者因下丘脑功能障碍和多器官功能衰竭死亡。
垂体瘤与视路之间的蛛网膜屏障是手术中保护视路的重要结构。将肿瘤与视路完全分离可实现肿瘤全切。垂体柄的术前定位和术中识别对保护垂体柄至关重要。
