神经导航及内镜辅助下经鼻蝶显微切除无功能性 垂体大腺瘤的近期疗效分析

Shortterm effect of neuronavigator and endoscope assisted endonasal transsphenoidal surgery for patients with nonfunctioning pituitary macroadenomas

摘要:

Abstract:

ObjectiveTo investigate the shortterm effect of neuronavigator and endoscope assisted endonasal transsphenoidal surgery for patients with nonfunctioning pituitary macroadenomas.MethodsClinical data of 62 patients with nonfunctioning pituitary macroadenomas received surgical treatment in our department from Jan 2013 to Sept 2014 were retrospectively analyzed. 62 patients were divided into two groups by whether to use neuronavigator and endoscopic technology or not, i.e. study group (32 cases) and control group (30 cases). Pituitary adenoma resection was performed with assistance of endoscope and neuronavigation in the study group. The indexes including surgery time, postoperative hospitalization duration, postoperative complications, changes of serum endocrinology, MRI, the residual and recurrence rates in the two groups were recorded and analyzed.ResultsThe time of hospital stays (6.6±0.7 d) in the study group was significantly less than that in control group (8.1±0.8 d). The postoperative complication rate (including transient diabetes insipidus, cerebrospinal fluid rhinorrhea, electrolyte disturbances, postoperative bleeding in the tumor cavity，hypopituitarism) in study group was also significantly lower than that in the control group (P<0.05). The postoperative remission rate of study group was significantly higher than that of the control group. The residual (2 cases) and recurrence (0 cases) rates in the study group were significantly lower than those in the control group (9 cases and 5 cases). According to the Knosp grade, the residual rate of the patients with Knosp grade=2 in the study group was lower than that of the control group, and the difference was statistically significant (P<0.05).ConclusionThe neuronavigator and endoscopic technology contribute to decrease the occurrence of the postoperative complications, to reduce residual and recurrence rate, and to improve the gross totalresection of tumor, is therefore effective for the treatment for patients with nonfunctioning pituitary macroadenomas.

Key words:Nonfunctioning pituitary macroadenomas|Neuronavigation| Endoscope|Clinical effect