中国全科医学2011，Vol.14Issue(6)：622-624,3.
分期经蝶入路手术治疗向鞍上生长的垂体无功能巨腺瘤的临床价值
Stagedly Transsphenoidal Operations on Giant Nonfunctioning Pituitary Adenoma with Suprasellar Extension
王剑新 1漆松涛 1彭玉平 1曾浩1
作者信息
- 1. 510515,广东省广州市,南方医科大学附属南方医院神经外科
- 折叠
摘要
Abstract
Objective To explore the clinic value of stagedly transsphenoidal operations on giant nonfunctioning pituitary adenoma with suprasellar extension. Methods The clinical data of 68 cases suffering from giant nonfunctioning pituitary adenoma with suprasellar extension ( SSE ) admitted into our department were retrospectively analyzed, who underwent primary transsphenoidal surgery, mainly include data on intraoperative treatment methods, adenoma remainders's turnover and treatment during following-up, and so on. Results All patients were treated transsphenoidally. 20 SSE adenomas were totally removed ( 20. 6％ ), and in other 48 cases ( 79. 4％ ), SSE residues were shown in MRI recheck in the 1st day after operation. After 3 months , the 3rd MRI was performed only to find that 21 remainders descended to sellar floor, 8 cases into intrasella, and 3 cases down to the level of stalk hypophysial and the entrance to the sella; all of resisdual tumors above got retranssphenoidal resection ( the total removal rate of desending SSE residues amount to 96. 9％ ); there were 2 adenoma remainders with slight descend, obvious SSE adenoms could be visible, which were preformed by a transtranial approach; other 12 cases with small SSE tumor remnants were given consecutive clinical observation, of which, 2 cases were aided by grammer knife because of unobvious visual promotion postoperatively. In the present goroup, there are 32 cases accepting stagedly transsphenoidal operations. The surgical mortality was 0％ . The mortality of our series was zero, and there were no case of rhinorrhea, meningitis or visual deterioration. 2 patients had supradiaphragmatic bleeding observed during routine postoperative CT that did not require operative revision. Conclusion Staged operations with two or multiple transsphenoidal resections of giant nonfunctioning pituitary adenoma with SSE have many advantages such as good therapeutic effects and few complications; At the same time, as the tumor grows larger, it should expand and shove the surrounding structures, not invade and destroy them; Further study need to be done in the growth pattern of pituitary adenoma.关键词
无功能垂体腺瘤/经蝶入路/分期手术分类
医药卫生引用本文复制引用
王剑新,漆松涛,彭玉平,曾浩..分期经蝶入路手术治疗向鞍上生长的垂体无功能巨腺瘤的临床价值[J].中国全科医学,2011,14(6):622-624,3.
