[1]孟肖利 万经海.神经内镜下经扩大鼻蝶入路手术切除颅咽管瘤[J].中国临床神经外科杂志,2019,(05):262-265.[doi:10.13798/j.issn.1009-153X.2019.05.002]
 MENG Xiao-li,WAN Jing-hai.Endosope-assisted neurosurgery through extended endonasal transsphenoidal approach for craniopharyngiomas[J].,2019,(05):262-265.[doi:10.13798/j.issn.1009-153X.2019.05.002]
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神经内镜下经扩大鼻蝶入路手术切除颅咽管瘤()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2019年05期
页码:
262-265
栏目:
论著
出版日期:
2019-05-27

文章信息/Info

Title:
Endosope-assisted neurosurgery through extended endonasal transsphenoidal approach for craniopharyngiomas
文章编号:
1009-153X(2019)05-0262-04
作者:
孟肖利 万经海
100021 北京,国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院神经外科(孟肖利、万经海)
Author(s):
MENG Xiao-li WAN Jing-hai
Department of Neurosurgery, National Cancer Center/National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
关键词:
颅咽管瘤神经内镜经扩大鼻蝶入路手术
Keywords:
Craniopharyngiomas Endoscope Neurosurgery Endonasal transsphenoidal surgery
分类号:
R 739.41; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2019.05.002
文献标志码:
A
摘要:
目的 探讨神经内镜经扩大鼻蝶入路手术切除颅咽管瘤的安全性和有效性。方法 回顾性分析2014 年11月至2017年11月神经内镜经扩大鼻蝶入路手术切除的18例颅咽管瘤的临床资料。结果 肿瘤全切除9例,近全切除7例,次全切除2例。术前视力、视野损伤16例中,10例好转;术前认知功能下降5例中,4例改善;术前皮质醇下降9例中,6例恢复正常;术前皮质醇正常9例中,2例皮质醇下降;术前尿崩3例中,1例缓解;术后发生一过性尿崩10例,1周后好转。术后脑脊液鼻漏1例(5.6%),保守治疗后好转。术后随访7~55个月,中位随访时间23.5个月, MRI未见肿瘤进展或复发。结论 神经内镜下经扩大鼻蝶入路手术切除颅咽管瘤安全、有效,关键是术前充分评估、掌握好适应证,术中保护好神经和血管、妥善修补颅底。
Abstract:
ObjectiveToinvestigatethecurativeeffectsofendoscope-assistedneurosurgerythroughextendedendonasaltranssphenoidalapproach(EETA)oncraniopharyngiomasanditssafety.MethodsTheclinicaldataof18patientswithcraniopharynbgiomasundergoingendoscope-assistedneurosurgerythroughEETAfromNovember,2014toNovember,2017wereanalyzedretrospectively.ResultsOf18patientswithcraniopharynbgiomas,9receivedtotalremovalofthetumorsand9subtotal.Of16patientswithpreoperativevisualacuitydefect,10wereobviouslyimprovedinthevisualacuitydefectand6not.Of5patientswithpreoperativecognitivefunctiondecline,4mendedand1not.Of9patientswithnormalpreoperativecortisollevel,2hadlowcortisolleveland7normalaftertheoperation.Of9patientswithlowpreoperativecortisollevel,6hadnormalcortisolleveland3notafterthesurgery.Tenpatientswhosufferedfromtransientdiabetesinsipidusaftertheoperationmended1weekaftertheoperation,andof3patientswithpreoperativediabetesinsipidus,1wasimprovedand2notaftertheoperation.Onepatientswhosufferedfromcerebrospinalfluidleakaftertheoperationmendedbytheconservativetreatment.ThepostoperativeMRIrevealednotumorprogressorrecurrenceinallthepatients7~55monthsaftertheoperation.ConclusionsSufficientpreoperativeevaluation,andavoidingintraoperativeneurologicalinjuryandreconstructingtheskullbaseareessentialforthesuccessfulresectionofcraniopharyngiomabyendosope-assistedneurosurgerythroughEETA.

参考文献/References:


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备注/Memo

备注/Memo:
基金项目:中国癌症基金会北京希望马拉松专项基金(LC2015L15)
通讯作者:万经海,E-mail:wanjinghai@sina.com
更新日期/Last Update: 2019-05-27