[多种技术辅助神经内镜治疗侵袭海绵窦的垂体腺瘤]
[Treatment of pituitary adenomas invading cavernous sinus with neuroendoscopy assisted by multiple techniques].
作者信息
Wei Zhen-qing, Wang Ren-zhi, Yao Yong, Deng Kan, Wang Jian-xin, Liu Xiao-hai, Dai Cong-xin
机构信息
Department of Neurosurgery,PUMC Hospital,CAMS and PUMC,Beijing 100730,China.
出版信息
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2014 Apr;36(2):189-93. doi: 10.3881/j.issn.1000-503X.2014.02.014.
OBJECTIVE
To study the effectiveness of treating giant pituitary adenomas invading cavernous sinus with neuroendoscopy assisted by multiple techniques.
METHODS
A total of 72 patients who underwent neuroendoscopic surgery and 55 patients who underwent microscopic surgery for giant pituitary adenomas were enrolled in this retrospective analysis. Both groups received expanded endoscopic endonasal transsphenoidal approach, intraoperative application of navigation, and Doppler.The clinical data of two groups were compared.
RESULTS
The two groups were significantly different in total tumor removal rate, operation time, postoperative nasal patency, and postoperative recurrence rate (P=0.004, P=0.0003, P=0.000, and P=0.002, respectively), whereas the cerebrospinal fluid leakage, postoperative diabetes insipidus, and cranial nerve injury were not significantly different (P > 0.05).
CONCLUSIONS
Expanded neuroendoscopic endonasal transsphenoidal approach assisted by multiple techniques is the preferred surgical method for giant invasive pituitary adenomas invading cavernous sinus.The lateral cavernous sinus approach and the further molecular biology research will bring more options for the treatment of invasive pituitary adenomas.
目的
探讨多种技术辅助神经内镜治疗侵袭海绵窦的巨大垂体腺瘤的疗效。
方法
本回顾性分析纳入了72例行神经内镜手术治疗的巨大垂体腺瘤患者和55例行显微手术治疗的患者。两组均采用扩大经鼻内镜经蝶入路，术中应用导航及多普勒。比较两组的临床资料。
结果
两组在肿瘤全切除率、手术时间、术后鼻腔通畅情况及术后复发率方面差异有统计学意义（分别为P = 0.004、P = 0.0003、P = 0.000及P = 0.002），而脑脊液漏、术后尿崩症及脑神经损伤差异无统计学意义（P > 0.05）。
结论
多种技术辅助的扩大经鼻内镜经蝶入路是治疗侵袭海绵窦的巨大侵袭性垂体腺瘤的首选手术方法。外侧海绵窦入路及进一步的分子生物学研究将为侵袭性垂体腺瘤的治疗带来更多选择。
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