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目的:为大型垂体腺瘤探索一种安全而有效的治疗方式。方法:总结183例大型垂体腺瘤的诊断、手术和治疗结果。肿瘤向鞍上扩展直径>10mm。在手术显微镜下经蝶入路行肿瘤切除术。结果:132例(72.1％)肿瘤获全切除;40例(21.9％)达次全切除;余11例(6.0％)系哑铃型或纤维性腺瘤,行部分切除。术后无死亡。对158例进行平均3.8年随访观察,其中115例(72.8％)恢复良好,43例(27.2％)肿瘤有复发,需行再次手术,或采用药物、放疗或放射外科治疗。结论:对非纤维性或哑铃状大型垂体腺瘤经蝶入路显微手术切除是一种安全、有效的方法。
Objective: To explore a safe and effective treatment for large pituitary adenomas. Methods: The diagnosis, surgery, and treatment of 183 large pituitary adenomas were summarized. The tumor expanded to a diameter of >10mm above the saddle. Transsphenoidal surgery was performed under a surgical microscope. Results: 132 (72.1%) tumors were totally resected; 40 (21.9%) were subtotal removed; 11 (6.0%) were dumbbell or fibrous adenomas and were partially removed. No deaths after surgery. An average of 3.8 years of follow-up observations were performed on 158 patients, of whom 115 (72.8%) recovered well and 43 (27.2%) had tumor recurrences. They required reoperation, medication, radiotherapy, or radiosurgery. Conclusion: Transsphenoidal microsurgical removal of non-fibrous or dumbbell-shaped large pituitary adenomas is a safe and effective method.