神经内镜经双侧鼻中隔黏膜下入路治疗垂体腺瘤的疗效分析.

Objective To explore the efficacy of neuroendoscopic transseptal submucosal approach in the surgical treatment of pituitary adenomas. Methods The clinical data of 50 patients with pituitary adenoma were analyzed retrospectively. According to the operation method, they were divided into mucosal approach group（n = 26） and classical approach group（n = 24）. The perioperative observation indexes（operation time, intraoperative bleeding, intraoperative cerebrospinal fluid leakage, postoperative hospital stay）, tumor resection rate,hormone biochemical remission rate and postoperative complication rate were compared and analyzed. Results There was no significant difference in operation time/intraoperative cerebrospinal fluid leakage/operation bleeding between mucosal approach group and classical approach group, P values（0. 089 7/0. 385/1. 000） were greater than 0. 05. In the effect of tumor resection, the total resection rate of the two groups was 88%,and there was no significant difference between the two groups（χ~2= 0. 110,P =0. 917）. The hormone biochemical remission rate was 83% in the mucosal approach group and 63%in the classical approach group. There was no significant difference between the two groups（χ~2=1. 847,P = 0. 174 > 0. 05）. In terms of postoperative complications, there was no significant difference in postoperative transient diabetes insipidus, intracranial infection and decline of pituitary function between the two groups（P > 0. 05,0. 174/1. 000/0. 480/0. 623,respectively）. The P values of postoperative hospital stay and nasal complications were 0. 001/0. 022 and less than0. 05, respectively. Conclusions Compared with the classic neuroendoscopic bilateral transsphenoidal approach for pituitary adenoma, the neuroendoscopic bilateral transseptal submucosal approach can better protect the nasal anatomy and function in pituitary tumor resection, and reduce postoperative hospital stay and nasal complication. It is also a safe and effective surgical method. [ABSTRACT FROM AUTHOR]