Kikuchi Ryogo, Toda Masahiro, Tomita Toshiki, Ogawa Kaoru, Yoshida Kazunari
Keio University School of Medicine, Department of Neurosurgery, Shinjuku, Tokyo, Japan.
Turk Neurosurg. 2017;27(1):1-7. doi: 10.5137/1019-5149.JTN.14354-15.0.
This study aimed to assess the efficacy of endoscopic endonasal surgery, conducted by a team of neurosurgeons and otolaryngologists.
We studied 40 patients who were undergoing surgery for primary non-functional pituitary adenomas with Knosp grades 1 to 3, at Keio University Hospital between 2005 and 2012. We compared the endoscopic endonasal transsphenoidal approach (team-eTSS; T-eTSS), with a microscopic transsphenoidal approach (mTSS). Analyses were conducted for differences between the two groups in tumor resection rates, operating durations, and complications from the non-functional pituitary adenomas. We also compared the heminostril and binostril approaches for T-eTSS.
Tumor resection rates were higher when the surgeries were conducted by T-eTSS than mTSS. In particular, when the maximum tumor diameter was more than 25 mm, resection rates were significantly higher for T-eTSS than for mTSS. There were no unexpected complications in either group. There was no significant difference in resection rates between the heminostril and binostril approaches when T-eTSS was performed.
T-eTSS is an efficacious surgical option for non-functional pituitary adenomas, particularly when the adenoma is of large size. Benefits of the heminostril approach are evident.
本研究旨在评估由神经外科医生和耳鼻喉科医生团队进行的鼻内镜手术的疗效。
我们研究了2005年至2012年期间在庆应义塾大学医院接受手术治疗的40例Knosp 1至3级原发性无功能垂体腺瘤患者。我们将鼻内镜经蝶窦入路（团队-经蝶窦手术；T-经蝶窦手术）与显微镜下经蝶窦入路（mTSS）进行了比较。分析了两组在肿瘤切除率、手术时间和无功能垂体腺瘤并发症方面的差异。我们还比较了T-经蝶窦手术的单侧鼻孔入路和双侧鼻孔入路。
T-经蝶窦手术的肿瘤切除率高于mTSS。特别是当肿瘤最大直径超过25mm时，T-经蝶窦手术的切除率显著高于mTSS。两组均未出现意外并发症。进行T-经蝶窦手术时，单侧鼻孔入路和双侧鼻孔入路的切除率无显著差异。
T-经蝶窦手术是治疗无功能垂体腺瘤的一种有效手术选择，尤其是当腺瘤体积较大时。单侧鼻孔入路的优势明显。
