【摘要】 目的 探讨内镜下经鼻蝶垂体瘤复发及残留再次手术的临床疗效。方法 回顾性分析2015年1月-2018年6月我院收治的69例垂体瘤患者,比较再次手术和首次手术的临床手术时间、术后住院时间、手术并发症、肿瘤全切率。结果 两次手术肿瘤全切率、手术时间差异无统计学意义(P>0.05),但再次手术的术后住院天数[(13.30±6.81)d]较首次手术[(9.60±3.55)d]延长,差异有统计学意义(t=2.16,P 0.05);再次手术并发症的发病率明显高于首次手术,尤其脑脊液漏、颅内感染、尿崩症的发病率明显增高,差异有统计学意义(P<0.05)。结论 内镜下经鼻蝶垂体瘤复发及残留再次手术的肿瘤全切率与首次手术差别不大,但术后并发症的发病率明显增加,术后住院天数延长,再次手术在切除肿瘤及保护重要邻近解剖结构方面较首次手术复杂性及难度明显提高。更多还原

【Abstract】 Objectives To investigate the clinical efficacy of endoscopic transsphenoidal reoperation for recurrent or residual pituitary adenoma. Methods A total of 69 patients with pituitary adenoma admitted from January 2015 to June 2018 were retrospectively analyzed. Operation time, postoperative length of stay,operation complication rates and resection rates were compared for both first-time operation and reoperation groups. Results There were no statistically significant differences in resection rates and operation time across the two groups(P > 0.05). However, the postoperative length of stay was significantly longer in reoperation group than that of the first-time operation group[(13.30±6.81)d vs(9.60±3.55)d; t=2.16,P<0.05]. There was also a significant difference in operation complication rates across the two groups, characterized by an increase in the occurrence of cerebrospinal fluid leakage, intracerebral infectious and diabetes insipidus in the reoperation group(P < 0.05). Conclusions The total resection rate of recurrent and residual endoscopic transsphenoidal pituitary adenomas is not significantly different from that of the first operation, but the incidence of complications increases significantly, the length of hospitalization after operation prolongs, and the complexity and difficulty of reoperation in resecting tumors and protecting important adjacent anatomical structures are significantly higher than those of the first operation.更多还原