CAJ | 학술논문

目的探讨再次经蝶入路手术(TSS)切除垂体腺瘤的手术策略. 方法回顾性收集自2003年1月至2012年10月福州总医院收治的23例再次TSS治疗垂体腺瘤患者的临床资料,分析其手术方法与治疗结果. 结果本次TSS均在显微镜下完成,4例采用神经导航引导手术,1例使用C臂机透视定位.肿瘤高度15～45 mm.全切除肿瘤12例,次全切除和大部切除10例,部分切除1例.有10例术中发生脑脊液漏.18例获得随访,术后出现展神经麻痹1例,长期尿崩1例,需依赖激素替代治疗1例. 结论再次TSS应尽可能更新手术进路,扩大肿瘤的显露范围,并警惕脑脊液漏的发生.
목적 탐토재차경접입로수술(TSS)절제수체선류적수술책략. 방법 회고성수집자2003년1월지2012년10월복주총의원수치적23례재차TSS치료수체선류환자적림상자료,분석기수술방법여치료결과. 결과 본차TSS균재현미경하완성,4례채용신경도항인도수술,1례사용C비궤투시정위.종류고도15～45 mm.전절제종류12례,차전절제화대부절제10례,부분절제1례.유10례술중발생뇌척액루.18례획득수방,술후출현전신경마비1례,장기뇨붕1례,수의뢰격소체대치료1례. 결론 재차TSS응진가능경신수술진로,확대종류적현로범위,병경척뇌척액루적발생.
Objective To explore the strategies of repeat transsphenoidal surgery (TSS) for pituitary adenomas.Methods Surgical techniques and treatment outcomes of 23 patients with pituitary adenomas,performed repeat TSS in our hospital from January 2003 to October 2012,were retrospectively analyzed.Results All repeat TSS were done under a microscope; four patients were performed navigation-guided surgery and one patient used C-arm fluoroscopy.The tumor heights were 15-45 mm,and the tumors were total removed in 12 cases,subtotal resection or most resection in 10 cases and partial removal in 1 case.There were 10 cases of cerebrospinal fluid leakage during operation.Eighteen cases were followed up,with postoperative abducens nerve palsy and long-term diabetes insipidus in one each case,and one case needed the hormone replacement therapy.Conclusion Repeat TSS should correct surgical approach as much as possible and enlarge the tumor' s exposure,and should be alert to the occurrence of cerebrospinal fluid leakage.