内镜潜水技术在垂体外科手术中的应用

目的 探讨内镜潜水技术在垂体外科手术中的应用方法、适应证、疗效和并发症.方法 回顾性分析99例内镜下经鼻垂体手术病人的临床资料,均计划采用内镜潜水技术.其中垂体腺瘤91例,垂体Rathke囊肿8例.结果 术中实际应用内镜潜水技术84例,随访3～6个月,其中肿瘤全切除60例,次全切除19例,部分切除5例.术中出现脑脊液漏1例,修补后无脑脊液漏.术后视力损害加重1例,治疗后恢复至术前水平.术后出现一过性尿崩症23例.15例因解剖和操作等原因未能实施潜水技术.结论 内镜潜水技术安全实用,可提高病变切除程度,相关并发症少,器械的水中操作技术仍需改进.

Application of endoscopic diving technique in pituitary surgery

Objective To investigate the application method,indications,outcome and complications of endoscopic diving technique in pituitary surgery.Methods Clinical data of 99 patients undergoing endoscopic pituitary surgery were analyzed retrospectively.The endoscopic diving technique was administered to all the patients during the surgery by planning,including 91 with pituitary adenomas and 8 Rathke cleft cysts.Results Endoscopic diving technique was applied in 84 patients actually.The total resection was achieved in 62 patients,subtotal in 19 and partial removal in 5 during a follow-up period of 3 to 6 months.Leakage of cerebrospinal fluid occurred in 1 patient during the operation,who recovered after repair.Visual loss occurred in 1 patient,who returned normal after the second surgery,and transient diabetes insipidus in 23 after operation.The remaining 15 patients failed to receive diving technique because of anatomy and manipulation.Conclusions Endoscopic diving technique is a safe and practical method which can increase the extent of tumor resection in pituitary surgery with less associated complications,but the underwater manipulation of instruments should be improved.