ラトケ嚢胞手術症例における長期治療成績の検討

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With the widespread availability and advances of MRI, the incidence of Rathke's cleft cyst (RCC) diagnosis is increasing. But surgical indication for RCC is uncertain, because natural history of RCC is unclear. A retrospective analysis was conducted in a consecutive series of 60 patients (16 males and 44 females, age: 14 to 69 years old, average: 38.1), 63 surgical cases (including 3 recurrences). They underwent transsphenoidal surgery between October 1998 and March 2005 at Tokyo Women's Medical University. The minimal and average follow-up periods were 36 and 65.8 months. Of these 63 operative cases, 39 (61.9%) patients demonstrated hypothalamic-pituitary dysfunction, 34 (54%) patients headaches, and 13 (20.6%) patients visual impairment. As for postoperative improvements rate of endocrine dysfunction, a single axis dysfunctions were improved highly (86.4%), whereas multiple axes dysfunctions improved poorly (48.1%). Furthermore, the more pituitary function disturbed (2, 3, 4, 5, and 6 axes), the less axes improved (73.1, 55.6, 31.3, 26.7, and 16.7%). Of 34 headache patients, 32 (94.1%) reported disappearance or improvement of this symptom postoperatively. All of 13 patients presenting with visual field disturbance were improved after the operation. Improvements in endocrine dysfunction, headaches, and visual impairment can be expected after surgical resection and irrigation of RCC.
東京女子医科大学の論文