Place An Order By Microscope Nostril Transsphenoidal Pituitary Tumor Resection

Objective:Place an order of microscope nostril transsphenoidal resection ofpituitary tumor effects and complications.Methods:During the period from2012to2014March to accept microscope placean ordernostril transsphenoidal pituitary tumor resection in69cases of pituitary tumorin patients with clinical data were retrospectively analyzed, summarized in ourhospital.These69patients were on preoperative related endocrine hormonetest, visualacuity, visual field examination, nasal cavity and explore the internal structure, brainCT and sellar region enhanced magnetic resonance scanning.Among them67caseswere elective operation patients were hospitalized,3days to complete the relevantadmission examinations were performed after operationtreatment,2cases in thehospital after emergency operation treatment (all giant invasive pituitary adenoma andadenoma apoplexy). Operation microscope is a German Carl Zeiss Companyproduction of ZEISS OPMI PENTERO.Results:According to the statistics of pituitary tumors were totally removed in67cases(about97%), partial resection of pituitary tumor2cases (about3%),0cases diedafter operation. The69patients in our hospital in the average hospital stay was7.5days.8cases of cerebrospinal fluid leakage were found during the operation,andpostoperative sellar repair and lumbar cistern tube drainage, nocerebrospinal fluidleakage after operation. Patients appeared in5cases of hypopituitarism,6cases ofwater and electrolyte disorders, a transient diabetes insipidus in5cases, intracranialinfection in0cases, the postoperative complications after short-term treatment during hospitalization were cured.Preoperative hormone level test abnormal patient46cases,review the hormone levels after operation,40patients recovered to normal, and theremaining6patients with hormone levels improved postoperatively;69patients hadnoserious postoperative complications, the general condition is good, does not affectthe normal life.30patients were discharged after3months follow-up(number ofremaining due to loss of follow-up or personal economic causes of future outpatienttimely review),29patients with headache symptoms were completely relieved,25patients visual acuity and visual field was better than that before the operation andfurther improvement is discharged. There were27patients who underwent sellarenhanced magnetic resonance imaging examination, examination results of the27patients with sella turcica region to restore the original physiological anatomy,2cases(one case with postoperative pathological diagnosis: the first tumor hormone mixedpituitary adenoma,aneurysm with tumor apoplexy; another example of tumor invasionof cavernous sinus which cannot be cut, residual recurrence), a two stage operationtherapy in our hospital, we improved the preoperative examination, performed undermicroscope and the original incision endonasal pituitary tumor resection, radicalresection of the tumor, postoperative follow-up again image examination, review theresults showed no residual, two operation results satisfactory. The operationmode ofoperation time is short, little pain, quick recovery, postoperative clinical symptomswere improved to different extent in no serious complications.Conclusions：Microsurgical operation is the main method for the treatment ofpituitary tumors,microscope place an order nostril transsphenoidal pituitary adenomaresectionhas been widely used in the clinic, it can be faster, more accurate to the focalregion, so that the whole operating procedures are simplified, save time and effort;microscope in the operation visual field is clear, the maximum to reduce the side injuryduring the resection of the tumor, more accurately, reduce theoperation risk; smalloperation wound, on the surrounding nerves, blood vessels and brain tissue stretchsmall, thereby reducing the postoperative complications,postoperative recovery speed.But because of the operation of small operating space, requires the operator to master the microanatomy application of microoperation equipment and skilled knowledgeunder the microscope, for not complete tumor resection under direct vision, requiringthe operator to havecertain experience in operation, with microsurgical operationoperation skills to accomplish. In short, the operation treatment method has betterclinical curative effect, also has been widely recognized by clinicians, is worth theclinical promotion.