【摘要】 目的　介绍经额外侧入路及显微手术技术切除 1例颅咽管瘤 ,2 0例大型、巨大型垂体腺瘤的经验。方法　所有病人均采用经额外侧入路。垂体腺瘤切除的要点 :①先切除鞍内鞍上的大部分肿瘤 ;②电灼并切断来自视神经、视交叉、颈内动脉及硬脑膜等处的肿瘤新生血管 ,切断一切供瘤及引流血管 ;③分片切除鞍上的瘤壁 ,电灼鞍内的瘤壁 ,同时全切残余的肿瘤 ;④保护好垂体柄。结果　 1例颅咽瘤壁 ,予以全切 ;2例大型、巨大型垂体腺瘤为次全切 ,其余为全切。本组无死亡及重残病例 ,所有病人术后情况良好 ,生活如常。结论　位于鞍区的肿瘤直径在 52mm以内 ,是可以经额外侧入路 ,采用显微手术 ,安全全切的。更多还原

【Abstract】 Objective To introduce the transfrontal lateral approach and the microsurgical operative technique for 1 case of craniopharengioma and 20 cases of large and giant pituitary adenoma. Methods All patients were operated via the transfrontal lateral approach. The main points of tumor resection for pituitary adenoma were as follows: ①The intrasellar and suprasellar parts of the tumor were largely removed. ②Numerous new fine tumor vessels arising from the optic nerves, the chiasm, the dura mater, and the carotid artery were coagulated and cut. ③The suprasellar part of the tumor wall was resected piece by piece, and at the same time, the remaining part of the tumor was totally removed. ④The pituitary stalk located in the posterior part of the tumor wall was protected. Results The cranio pharengioma was totally removed. The pituitary adenoma was totally removed, the suprasellar portion of the tumor wall was excised and the intrasellar portion of the tumor wall was coagulated in 18 cases. In 2 cases the tumor was subtotally removed. All cases got good results after the operation. Conclusion We can totally remove the tumor which is located in the sellar area and its diameter is less than 52 mm, reserve the pituitary stalk, excise the suprasellar portion of the capsule of the tumor, and coagulate the intrasellar portion of the tumor wall by microsurgical techniques via the transfrontal lateral key hole approach. All of these lay a solid foundation for the preventoin of tumor recrudescence.更多还原