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The optimal surgical techniques for pituitary tumors.
Best Practice & Research Clinical Endocrinology & Metabolism ( IF 6.1 ) Pub Date : 2019-07-27 , DOI: 10.1016/j.beem.2019.101299
M Buchfelder 1 , S M Schlaffer 1 , Y Zhao 1
Affiliation  

In this paper, the currently used and well evaluated techniques for the surgery of pituitary tumors will be reviewed. Since the first surgical approaches to pituitary tumors more than 100 years have elapsed. Various surgical techniques have been developed, refined and standardized. Most of these tumors are to date treated via transsphenoidal approaches. Many pituitary adenomas, particularly, smaller, enclosed ones, can be completely excised and a selective adenomectomy is usually attempted. It leads to remission of hormonal oversecretion and also to recovery of pituitary function in many patients. The resection of pseudocapsule around the adenoma seems to improve the operative results further. Transcranial approaches, employing craniotomies, are still needed in some patients with pituitary adenomas and in many of those harbouring craniopharyngiomas. The operative techniques will be described and briefly commented. Moreover, the application and usefulness of several technical developments will be reviewed, such as the use of the endoscope, magnetic resonance imaging, fluorenscent dyes and neuronavigation. The use of the intraoperative Doppler probe, ultrasound and the value of intraoperative hormonal measurements will be briefly discussed. There is sufficient evidence that the best and optimal outcome in terms of tumor resection and correction of hormonal oversecretion as well as the lowest rate of complications are obtained in centers of excellence with sufficiently experienced, specialized surgeons and a high patient load.

中文翻译:

垂体肿瘤的最佳手术技术。

在本文中,将对垂体瘤手术的当前使用和经过良好评估的技术进行综述。自从首次手术治疗垂体肿瘤以来,已经有100多年的历史了。已经开发,完善和标准化了各种外科技术。迄今为止,大多数这些肿瘤都是通过蝶窦入路治疗的。许多垂体腺瘤,特别是较小的封闭腺瘤可以完全切除,通常尝试进行选择性腺瘤切除术。在许多患者中,其导致激素过度分泌的减轻以及垂体功能的恢复。切除腺瘤周围的假囊似乎可以进一步改善手术效果。经颅手术,开颅手术,在一些垂体腺瘤患者和许多颅咽咽管瘤患者中,仍需要使用。将描述手术技术并作简要评论。此外,将回顾一些技术发展的应用和有用性,例如内窥镜的使用,磁共振成像,荧光染料和神经导航。将简要讨论术中多普勒探头的使用,超声检查和术中荷尔蒙测量的价值。有足够的证据表明,在经验丰富,专业的外科医生和高患者负担的卓越中心,可以获得肿瘤切除和荷尔蒙分泌过多矫正方面的最佳和最佳结果,以及并发症的发生率最低。将描述手术技术并作简要评论。此外,将回顾一些技术发展的应用和有用性,例如内窥镜的使用,磁共振成像,荧光染料和神经导航。将简要讨论术中多普勒探头的使用,超声检查和术中荷尔蒙测量的价值。有足够的证据表明,在经验丰富,专业的外科医生和高患者负担的卓越中心,可以获得肿瘤切除和荷尔蒙分泌过多矫正方面的最佳和最佳结果,以及并发症的发生率最低。将描述手术技术并作简要评论。此外,将回顾一些技术发展的应用和有用性,例如内窥镜的使用,磁共振成像,荧光染料和神经导航。将简要讨论术中多普勒探头的使用,超声检查和术中荷尔蒙测量的价值。有足够的证据表明,在经验丰富,专业的外科医生和高患者负担的卓越中心,可以获得肿瘤切除和荷尔蒙分泌过多矫正方面的最佳和最佳结果,以及并发症的发生率最低。荧光染料和神经导航。将简要讨论术中多普勒探头的使用,超声检查和术中荷尔蒙测量的价值。有足够的证据表明,在经验丰富,专业的外科医生和高患者负担的卓越中心,可以获得肿瘤切除和荷尔蒙分泌过多矫正方面的最佳和最佳结果,以及并发症的发生率最低。荧光染料和神经导航。将简要讨论术中多普勒探头的使用,超声检查和术中荷尔蒙测量的价值。有足够的证据表明,在经验丰富,专业的外科医生和高患者负担的卓越中心,可以获得肿瘤切除和荷尔蒙分泌过多矫正方面的最佳和最佳结果,以及并发症的发生率最低。
更新日期:2019-07-27
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