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目的 总结经颅翼点人路显微切除侵袭型垂体腺瘤的经验,争取尽可能对肿瘤全切,减少并发症。方法2000年至2004年采用Yasargil翼点入路在显微镜下切除侵袭型垂体腺瘤57例,全部属于Hardy分级Ⅲ级以上的侵袭型垂体腺瘤,术中注意充分利用鞍区周围的各个自然解剖间隙,应用良好的显微技术切除向各个方向侵袭生长的肿瘤。结果 全组病例无死亡,无与手术相关的新的神经功能障碍,获得显微镜下全切49例,占86％,次全切8例。结论 型垂体腺瘤的显微手术在绝大多数情况下可以经翼点入路完成,熟练掌握规范的手术入路和局部显微解剖以及良好的显微外科技巧是保证手术疗效的根本。
Objective To summarize the experience of microsurgical removal of invasive pituitary adenoma through the cranial wing point pathways, and strive to achieve full resection of the tumor and reduce the complications. Methods Totally 57 cases of invasive pituitary adenoma were excised by Yasargil pterion approach from 2000 to 2004. All of them were invasive pituitary adenomas with Hardy grade Ⅲ or higher. All the anatomy around the sellar area Gaps, well-applied microsurgical techniques to excise the growing tumor in all directions. Results There was no death and no new neurological dysfunction associated with surgery in all the patients. 49 patients underwent total radical resection (86%) under microscope, and 8 patients underwent subtotal resection. Conclusions Microsurgery of pituitary adenoma can be accomplished via pterional approach in the majority of cases. Proficiency in standardized surgical approaches, local microsurgical anatomy, and good microsurgical skills are fundamental to the efficacy of surgery.