| Objective:Pituitary tumor is a common clinical central nervous system tumors, second only in brain glioma and meningioma tumors, the incidence rate of about 10%.With the development of imaging technology and the popularity,the clinical diagnosis of pituitary tumors has increased the rate. According to the secretion of hormone secretion or whether,the type of pituitary tumor is divided into several different pathological types;PRL is the most common type of pituitary tumor, there are typical clinical manifestations and changes in hormone levels, clinical symptoms and hormone levels after treatment changed significantly. There are several methods of the treatment of pituitary tumor surgery, such as drug therapy, radiotherapy, each method has a definite effect on the appropriate cases. Surgery is the current mainstream.In general the surgical treatment of pituitary tumors through the Craniotomy,sublabial, transsphenoidal approach.The development process also reflected the nervous system disease trends in minimally invasive surgery. A century ago, the surgeon carried out the surgical treatment of pituitary tumors, limited by equipments,craniotomy surgery occupied the mainstream. With the development of neurosurgery technology, the transsphenoidal approach gradually had been accepted, and some people try to Endoscopic technology into neurosurgery, but the limited material endoscopic and imaging technology, Endoscopic surgery no advantage relative to microsurgery. Development of the last two decades Endoscopic technology has been adapted in structure and surgical treatment of pituitary tumors, more and more widely used in clinical. To clear the surgical treatment of pituitary tumors with or without difference, this article will explore the endoscopic surgery and endonasal microsurgery for pituitary tumor resection safety and clinical effects. Methods:Collected 60 cases of pituitary tumor in January 2009 ~ May 2010, for ease of comparing results of operations, all patients were prolactin pituitary tumors, and has not ruled out by the transsphenoidal approach for patients.32 cases of pituitary adenoma were treated by endoscopic endonasal transsphenoidal surgery;28 cases were treated via microscopy endonasal transsphenoidal surgery. Various outcomes measures were used including: operating time, extent of tumor resection, postoperative normalization of hormone levels,incidence of complications, blood loss,length of hospital stay,and patient pain and discomforta,all patients got a follow-up of 6 months. Results:Neuroendoscopy unit tumor removal was total 26 cases, visual acuity improved in 16 cases, 17 cases of normal menstruation, To stop lactation in 18 patients, 1 case of cerebrospinal fluid leakage, 1 case of diabetes insipidus;hospitalizationg time 5.0(d )±1.6(d),blood loss 50.0(ml)±8.4(ml),operation lasted 97.6(min)±9.0(min).Microscopy unit tumor removal was total 27 cases, visual acuity improved in 17 cases, 16 cases of normal menstruation, to stop lactation in 18 patients, 4 cases of cerebrospinal fluid leakage,2 cases of diabetes insipidus, 2 cases of infection, 1 case of intracranial hemorrhage, 1 case of hypopituitarism; hospitalizationg time 7.4(d)±1.1(d), blood loss 80. 4(ml)±7.4(ml),operation lasted 155.0(min)±15.7(min) .Conclusion:Endoscopic surgery is better than microscopy in the surgical cavity in the deep sense ,and have more space instrumentation.But endoscopic surgery is of advantages as minimal invasiveness, avoids postoperative nasal septum, and the tumor revealed clear exposure. Major outcome measures (extent of tumor resection, changes in hormone levels) do not differ between the two approaches. Complications, time in the operating room and hospital,incidence of complications,and patient discomfort are significantly less with the endoscopic approach. But when the tumor invaded the cavernous sinus, extent of tumor resection, postoperative normalization of hormone levels,endoscopic has more obvious advantages than microsurgery. |
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