Guidetti B, Fraioli B, Cantore G P
Acta Neurochir (Wien). 1987;85(3-4):117-24. doi: 10.1007/BF01456107.
Of the 510 patients with pituitary adenoma treated surgically at our hospital in the period 1956-1984 319 were treated by the microsurgical technique, in the period 1973-1984, 235 by transsphenoidal approach and 84 by subfrontal-pterional approach. The transsphenoidal route was used almost exclusively in microadenomas, in intrasellar adenomas, in suprasellar adenomas with midline development, in adenomas invading the sphenoidal sinus and in haemorrhagic adenomas with considerable suprasellar development. In some giant adenomas the transsphenoidal route was used in a first stage operation for debulking the tumour, later removed by transcranial route. The latter route was preferred in large adenomas and especially in adenomas with laterosellar development. In some patients with PRL secreting adenomas post-operative treatment with bromocriptine proved useful when the hormone levels failed to normalize. Post-operative radiotherapy was of value in invasive adenomas and in cases in which tumour removal was not radical.
1956年至1984年期间，在我院接受手术治疗的510例垂体腺瘤患者中，319例采用显微外科技术治疗；1973年至1984年期间，235例采用经蝶窦入路，84例采用额下-翼点入路。经蝶窦入路几乎仅用于微腺瘤、鞍内腺瘤、向中线发展的鞍上腺瘤、侵犯蝶窦的腺瘤以及具有明显鞍上发展的出血性腺瘤。在一些巨大腺瘤中，经蝶窦入路用于一期手术以减少肿瘤体积，随后通过经颅途径切除。后一种入路在大型腺瘤中更受青睐，尤其是向鞍旁发展的腺瘤。在一些泌乳素分泌性腺瘤患者中，当激素水平未能恢复正常时，术后使用溴隐亭治疗被证明是有效的。术后放疗对侵袭性腺瘤以及肿瘤切除不彻底的病例有价值。
