临床神经外科杂志Issue(2)：119-122,128,5.DOI:10.3969/j.issn.1672-7770.2019.02.006
神经导航多模态系统辅助神经内镜在 KnospⅢ、Ⅳ级垂体腺瘤手术中的应用
Neuronavigation multimodal system assisted neuroendoscopy in Knosp Ⅲ,Ⅳ pituitary adenoma surgery
摘要
Abstract
Objective To investigate the application of neuroendoscopy combined with neuronavigation in invasive pituitary adenoma resection.Methods The clinical data of 104 patients with invasive pituitary adenomas treated by neurosurgery in the First Affiliated Hospital of China Medical University from January 2014 to January 2018, were analyzed retrospectively.Of 104 patients, 70 of invasive pituitary adenoma resection ( neuronavigation group ) were performed with the aid of neuronavigation multimodal system and 34 were performed with traditional surgery without intraoperative imaging guidance ( control group ).The degree of surgical resection of invasive pituitary adenoma, the incidence of postoperative complications and the recurrence rate were compared between the two groups.Results In the control group, 20 cases ( 58.8%) were completely resected.In the neuronavigation group , 59 cases ( 84.3%) underwent complete resection.There was significant difference between the two groups in tumor resection ( P＜0.05). Postoperative complications observed in 10 patients (14.3%) in the neuronavigation group showed diabetes insipidus was in 4 cases, cerebrospinal fluid rhinorrhea in 4 and vision loss in 2.In contrast, 18 cases ( 52.9%) had postoperative complications , including 1 of postoperative hemorrhage, 6 of diabetes insipidus, 5 of visual acuity loss and 6 of cerebrospinal fluid rhinorrhea. The incidence of postoperative complications in the control group was significantly higher than that in the neuronavigation group.There was significant difference in the incidence of complications between the two groups ( P ＜0.05 ).During follow-up, 5 patients in the control group who underwent subtotal or partial resection recurred within 12 months.Conclusions The multimodal neuronavigation system can present the lesion and its spatial relationship with adjacent nerve vessels in real time during the operation.It can significantly increase the total removal rate of invasive pituitary adenoma and reduce the incidence of complications and recurrence.The combination of multimodal neuronavigation system and endoscopy has become an important tool for guiding invasive pituitary adenomas.关键词
侵袭性垂体腺瘤/神经导航多模态系统/神经内镜/三维重建Key words
invasive pituitary adenoma / neuronavigation multimodal system / neuroendoscopy /3D reconstruction分类
医药卫生引用本文复制引用
CHEN Lian,ZHAO Jun-shuang,SUN Guang-ye..神经导航多模态系统辅助神经内镜在 KnospⅢ、Ⅳ级垂体腺瘤手术中的应用[J].临床神经外科杂志,2019,(2):119-122,128,5.基金项目
辽宁省自然科学基金(20170541022) （20170541022）
