CAJ | 학술논문

目的探讨经蝶窦入路显微切除颅咽管瘤的手术技巧及适应证.方法回顾性分析了18例经蝶入路显微手术切除的颅咽管瘤病例的临床资料、手术技巧、疗效预后.结果所有病例中15例获得全切,1例次全切,2例部分切除,无手术死亡.术后无脑脊液鼻漏,仅1例并发短期尿崩,无严重水电解质失衡.随访资料显示术前临床症状在术后均得到了不同程度的缓解.结论肿瘤主体部分位于鞍内,向蝶窦方向扩张,或向鞍上扩张但以囊性为主的,适合采用经蝶入路;术者丰富的经蝶入路经验和娴熟的显微技术是保证手术成功、减少并发症的关键.
목적 탐토경접두입로현미절제로인관류적수술기교급괄응증.방법 회고성분석료18례경접입로현미수술절제적로인관류병례적림상자료、수술기교、료효예후.결과 소유병례중15례획득전절,1례차전절,2례부분절제,무수술사망.술후무뇌척액비루,부1례병발단기뇨붕,무엄중수전해질실형.수방자료현시술전림상증상재술후균득도료불동정도적완해.결론 종류주체부분위우안내,향접두방향확장,혹향안상확장단이낭성위주적,괄합채용경접입로;술자봉부적경접입로경험화한숙적현미기술시보증수술성공、감소병발증적관건.
Objective To explore the operative techniques and indications of microsurgical resection of craniopharyngioma via transsphenoidul approach. Method The clinical data, operative techniques, curative effects and prognosis of the eighteen cases with complete information and treated in our department via transsphenoidal approach, were analyzed retrospectively. Results All cases were ordered microsurgical resection via transsphenoidal approach. Total removal of the tumors were achieved in 15 cases,subtotal removal in 1 cases, and partially removal in 2 cases. There was no operative death and postope rativedeath, no postoperative cerebralspinal rhinorrhea, and no severe postoperative water-electrolytes imbalance.And short term diabetes iusipidus happened in one case. Following-up data showed that the preope rativeclinical symptoms were relieved postoperatively of different degree. Conclusions Tumors that main part of which locates in the sells turcica, with expansion to the sphenoidal sinus, or with cystic extentsion to the suprasellar, are indications of microsurgical resection via transsphenoidal approach. Surgeon's operative experience of transsphenoidal approach and skilled microsurgical technique is the key point of successful operation and reduction of postoperative complications.