| objective: Discussion nerve endoscopic microscopy and single transsphenoidalpituitary tumor resection advantages and disadvantages, provide reference basis foroperation in patients with pituitary tumor treatment options, and discussed thepituitary tumor minimally invasive surgery development prospects.Methods: Collection and analysis of January2011-January2013prolactin pituitaryadenoma in Xinjiang Uygur Autonomous Region People’s Hospital of Neurosurgery,the same group of neurosurgeons use the two different surgical treatments for thestudy. Strict inclusion and exclusion criteria,40cases in each microscope andendoscope cases, and the control group was established as the microscope group, theobservation group for endoscopic groups, The clinical data of patients were collectedretrospectively analyzed two groups of patients with general information, tumorvolume, tumor type, resection, mean operative time, postoperative hospitalizationtime, blood loss, hormone changes before and after surgery, postoperative disease andrelapse, all patients were followed up for1year.Results: the microscope group male20cases, female20cases; mean age (42.5±11.62)(19~71) years; the average duration of (19.31±20.68) months (3days to8years), tumor size (measured in MRI maximum diameter calculation)(2.51±0.60)(cm),6cases of Hardy type Ⅱ, Ⅲ type in29cases,5cases of type IV, preoperativePRL (119.43±67.12)(ng/ml), PRL after operation (35.25±21.67)(ng/ml) PRLdecreased (84.18±52.59)(ng/ml), total resection of tumor in31cases (77.5%),subtotal in9cases (22.5%), operation time(14434.2)(min）, the intraoperative blood(76.88±11.19)(ml), mean postoperative hospital stay time (10.851.90)(d),3casesof postoperative diabetes insipidus, CSF leakage in4cases,2cases of nasal septumperforation,1cases of fever,17electrolyte disturbance cases,11cases ofpostoperative recurrence, recurrence in patients with PRL (74.92±33.57)(ng/ml).Endoscopic group male14cases, female26cases; mean age (40.95±12.10)(19~71) years; the average duration of (26.88±28.59) months (3days to10years),tumor size (measured in MRI maximum diameter calculation)(2.48±0.67)(cm),9cases of Hardy type Ⅱ, Ⅲ type in26cases,5cases of type IV, preoperative PRL(72.68±108.43)(ng/ml), PRL after operation (27.11±31.43)(ng/ml), PRL decreased(45.57±92.69)(ng/ml), total resection of tumor in38cases (95%), subtotal in2cases(5%), operation time（127.832.4）（min）, bleeding (47.25±11.81)(ml), meanpostoperative hospital stay time (6.831.23)(d), postoperative diabetes insipidus in1cases,2cases of cerebrospinal fluid leakage,21cases of disorder of electrolyte, followed up for1years after operation,4cases of recurrence, recurrenceinpatientswith PRL (86.7±39.4)(ng/ml).Conclusion: the two groups of patients with general information (age, course ofdisease, clinical symptoms, tumor size, tumor type) were not significantly different,but the rate of total resection of the tumor, operation time, intraoperative bleedingvolume, postoperative hospital stay, postoperative complications, recurrence, therewere obvious differences. Under the microscope transsphenoidal pituitary tumorresection surgery space, three-dimensional imaging, the surgeon is easy to master thetechnology, PRL levels were significantly decreased after surgery, But Endoscopicresection of the tumor hanging over the microscope with a more minimally invasive,safe and effective advantage. Endoscopic Mononostril transsphenoidal pituitary tumorresection is the best surgical treatment for patients with certain reference significancefor clinical work.. |
