CAJ | 학술논문

目的探讨内镜经鼻入路治疗垂体腺瘤的手术技巧,分析肿瘤全切除和内分泌缓解的相关影响因素.方法回顾性分析2011年3月至2013年8月138例内镜经鼻入路垂体腺瘤手术.经鼻入路包含常规经鼻-蝶窦入路和经鼻-筛窦入路(4例)、经鼻-上颌窦入路(1例)、经鼻-斜坡入路(1例).结果根据术后影像学和内分泌检查结果,全切除108例(78.3％),功能型垂体腺瘤内分泌缓解31例(44％).术后严重并发症有颅内感染(4例)和颅内出血(1例).结论肿瘤全切除率和内分泌缓解率,与肿瘤体积和是否侵袭海绵窦有关,影响侵袭性功能型垂体腺瘤内分泌缓解率的因素有肿瘤侵袭方向、侵袭程度及术者的手术经验.
목적 탐토내경경비입로치료수체선류적수술기교,분석종류전절제화내분비완해적상관영향인소.방법 회고성분석2011년3월지2013년8월138례내경경비입로수체선류수술.경비입로포함상규경비-접두입로화경비-사두입로(4례)、경비-상합두입로(1례)、경비-사파입로(1례).결과 근거술후영상학화내분비검사결과,전절제108례(78.3％),공능형수체선류내분비완해31례(44％).술후엄중병발증유로내감염(4례)화로내출혈(1례).결론 종류전절제솔화내분비완해솔,여종류체적화시부침습해면두유관,영향침습성공능형수체선류내분비완해솔적인소유종류침습방향、침습정도급술자적수술경험.
Objective To study the surgical techniques and analyze the related factors affecting the tumor total removal and postoperative endocrinological remission for endoscopic endonasal pituitary adenomas surgery.Methods The cases of endoscopic endonasal pituitary adenomas surgery from March 2011 to August 2013 were retrospectively analyze.The endonasal approaches included the routine transnasal-sphenoidal approach,transnasal-maxillary sinus approach in 4 cases and transnasal-clivus approach in one case.Results According to the postoperative imaging data and endocrine examination results,the total removal of tumors was achieved in 108 patients (78.3％),and the endocrinological remission was achieved in 31 patients (44％) with functional adenomas.The serious postoperative complications included four cases of intracranial infection and one case of intracranial hemorrhage.Conclusions The tumor size and invasiveness of cavernous sinus were related to the total removal rate and endocrinological remission rate.The direction and degree of tumor invasion,and the surgeon's experience were the key influence factors of the endocrinological remission rate for invasive functional pituitary adenomas.