Surgical Indications for and Limitations of Staged Transsphenoidal Surgery for Large Pituitary Tumors
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概要
- 論文の詳細を見る
Surgical indications and limitations of transsphenoidal surgery and intentionally staged transsphenoidal surgery for large pituitary tumors were investigated by retrospective analysis of the surgical and neuroradiological findings of 22 patients with large tumor and suprasellar extension. Twelv epatients underwent intentionally staged transsphenoidal surgery, and 10 underwent combined transsphenoidal and transcranial surgeries. Successful removal by intentionally staged surgery required descent of the suprasellar part following the first transsphenoidal surgery. Analysis showed that a smooth suprasellar extension and/or soft fumor are indications for intentionally staged transsphenoidal surgery even in patients with small sella. However, lobulated suprasellar extension, fibrous and firmtumor without descent, and small sella with normal pituitary gland loccated at the bottom of the sella are contraindications for staged transsphenoidal surgery. The first transsphenoidal surgery is always indicated to achieve histological confirmation and decompression of optic nerves. Transcranial Surgery should be attempted instead of repeated transsphenoidal surgeries when the residual tumor does not descend following the first transsphenoidal surgery.
- 日本脳神経外科学会の論文
- 1998-04-15
著者
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横山 徹夫
浜松医科大学脳神経外科
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横山 徹夫
浜岡総合病院 脳神経外科
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横山 徹夫
市立御前崎総合病院 脳神経外科
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太田 誠志
浜松医科大学 脳神経外科
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NISHIZAWA Shigeru
Department of Neurosurgery, University of Occupational and Environmental Health
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YOKOYAMA Tetsuo
Department of Neurosurgery, Hamamatsu University School of Medicine
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UEMURA Kenichi
Department of Neurosurgery, Hamamatsu University School of Medicine
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横山 徹夫
浜松医科大学脳外科
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OHTA Seiji
Department of Neurosurgery, Hamamatsu University School of Medicine
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Nishizawa Shigeru
Department Of Neurosurgery University Of Occupational And Environmental Health
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Nishizawa Shigeru
Department Of Neurosurgery Hamamatsu University School Of Medicine
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Nishizawa Shigeru
Departments Of Neurosurgery
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Ohta Seiji
Departments Of Neurosurgery Hamamatsu University School Of Medicine
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Uemura Kenichi
Department Of Neurosurgey Hamamatsu University School Of Medicine
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Uemura Kenichi
Department Of Neurological Surgery Chiba Unibersity
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Yokoyama Tetsuo
Department Of Neurosurgery Hamamatsu University School Of Medicine
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西澤 茂
Department of Neurosurgey, Hamamatsu University School of Medicine
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西澤 茂
Department of Neurosurgery, University of Occupational and Environmental Health
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