CAJ | 학술논문

目的探讨内镜经鼻蝶入路手术治疗老年人垂体腺瘤的技术和方法. 方法对2003年6月至2012年6月间治疗的42例老年垂体腺瘤患者进行回顾性分析,术前均行头CT、MRI及内分泌学检查,手术采用内镜经鼻蝶入路肿瘤切除术. 结果本组患者中肿瘤全切除25例(59.5％),近全切除8例(19.1％),部分切除9例(21.4％),死亡1例.术后随访6～36个月,患者视力、视野障碍均有所改善,20例需激素替代治疗,肿瘤残余12例,5例行伽马刀治疗. 结论内镜经鼻蝶入路手术是治疗老年人垂体腺瘤微创、安全的方法,加强围术期处理是手术成功的关键.
목적 탐토내경경비접입로수술치료노년인수체선류적기술화방법. 방법 대2003년6월지2012년6월간치료적42례노년수체선류환자진행회고성분석,술전균행두CT、MRI급내분비학검사,수술채용내경경비접입로종류절제술. 결과 본조환자중종류전절제25례(59.5％),근전절제8례(19.1％),부분절제9례(21.4％),사망1례.술후수방6～36개월,환자시력、시야장애균유소개선,20례수격소체대치료,종류잔여12례,5례행가마도치료. 결론 내경경비접입로수술시치료노년인수체선류미창、안전적방법,가강위술기처리시수술성공적관건.
Objective To discuss the operative techniques of endoscopic endonasal transsphenoidal surgery for the resection of pituitary adenoma in elderly patients.Methods From June 2003 to June 2012,a retrospective analysis of 42 elderly patients with pituitary adenoma was conducted.Computed tomography (CT) scan,magnetic resonance imaging (MRI) scan,and endocrinological examinations were performed in all patients before operation.All patients underwent endoscopic endonasal transsphenoidal surgery for the resection of pituitary adenoma.Results The tumors were totally removed in 25 cases (59.5％),sub-totally removed in 8 cases (19.1％) and partly removed in 9 cases (21.4％).1 patient died after operaion.Patients were followed up for 6-36 months.The visual acuity and visual field were improved.Hormone replacement therapy were needed in 20 patients due to hypopituitarism.Tumor residuals were found in 12 patients,among whom 5 patients were treated by γ-knife radiosurgery.Conclusions The endoscopic endonasal transsphenoidal operation is minimally invasive and safe for the treatment of pituitary adenoma in elderly patients.The strengthening of perioperative management is the key to the successful operation.