经鼻蝶垂体瘤切除术后主要并发症的诊疗进展
Progress in Diagnosis and Treatment of Major Complications after Transsphenoidal Pituitary Adenoma Resection
摘要: 本文综述了近年来关于经鼻内镜下垂体瘤切除术并发症的相关文献,对经鼻垂体瘤术后常见并发症进行系统综述,旨在提高临床医生对该手术并发症的认识和预防。经鼻内镜下垂体瘤切除术已成为一种主流的微创手术方法,但并发症仍不可避免,只有通过精细的操作、严密的术中监测和术后护理,大部分并发症才可以得到有效预防和治疗。临床医生应充分了解这些并发症,并在手术过程中采取相应措施,以提高手术安全性和患者生活质量。
Abstract: In this paper, the related kinds of literature about the complications of transsphenoidal pituitary adenoma resection in recent years are reviewed, and the common complications after transsphenoidal pituitary adenoma resection are systematically reviewed, in order to improve clinicians’ understanding and prevention of the complications. Endoscopic pituitary adenoma resection has become a mainstream minimally invasive surgical method, but complications are still inevitable. Only through careful operation, strict intraoperative monitoring and postoperative care can most complications be effectively prevented and treated. Clinicians should be fully aware of these complications and take corresponding measures during the operation to improve the safety of the operation and the quality of life of patients.
文章引用:岳胜涛, 陈晋. 经鼻蝶垂体瘤切除术后主要并发症的诊疗进展[J]. 临床医学进展, 2025, 15(2): 1436-1440. https://doi.org/10.12677/acm.2025.152493

参考文献

[1] Melmed, S. (2020) Pituitary-Tumor Endocrinopathies. New England Journal of Medicine, 382, 937-950. [Google Scholar] [CrossRef] [PubMed]
[2] Ezzat, S., Asa, S.L., Couldwell, W.T., Barr, C.E., Dodge, W.E., Vance, M.L., et al. (2004) The Prevalence of Pituitary Adenomas: A Systematic Review. Cancer, 101, 613-619. [Google Scholar] [CrossRef] [PubMed]
[3] Chowdhury, T., Prabhakar, H., Bithal, P., Schaller, B. and Dash, H. (2014) Immediate Postoperative Complications in Transsphenoidal Pituitary Surgery: A Prospective Study. Saudi Journal of Anaesthesia, 8, 335-341. [Google Scholar] [CrossRef] [PubMed]
[4] Esposito, F., Dusick, J.R., Fatemi, N. and Kelly, D.F. (2007) Graded Repair of Cranial Base Defects and Cerebrospinal Fluid Leaks in Transsphenoidal Surgery. Operative Neurosurgery, 60, 295-304. [Google Scholar] [CrossRef] [PubMed]
[5] Fiacchini, G., De Santi, S., Trico, D., Cambi, C., Seccia, V., Cristofani-Mencacci, L., et al. (2020) Comparison of a Purely Endoscopic Three-Layer Technique versus Pericranial Flap for Reconstruction of Anterior Skull Base Defects after Sino-Nasal Tumor Resection: Assessment of Postoperative Frontal Lobe Sagging and Frontal Lobe Falling. Rhinology Journal, 58, 482-488. [Google Scholar] [CrossRef] [PubMed]
[6] Eloy, J.A., Choudhry, O.J., Shukla, P.A., Kuperan, A.B., Friedel, M.E. and Liu, J.K. (2012) Nasoseptal Flap Repair after Endoscopic Transsellar versus Expanded Endonasal Approaches: Is There an Increased Risk of Postoperative Cerebrospinal Fluid Leak? The Laryngoscope, 122, 1219-1225. [Google Scholar] [CrossRef] [PubMed]
[7] Nemergut, E.C., Zuo, Z., Jane, J.A. and Laws, E.R. (2005) Predictors of Diabetes Insipidus after Transsphenoidal Surgery: A Review of 881 Patients. Journal of Neurosurgery, 103, 448-454. [Google Scholar] [CrossRef] [PubMed]
[8] 周良辅. 现代神经外科学[M]. 上海: 复旦大学出版社, 2001.
[9] Fleseriu, M., Christ-Crain, M., Langlois, F., Gadelha, M. and Melmed, S. (2024) Hypopituitarism. The Lancet, 403, 2632-2648. [Google Scholar] [CrossRef] [PubMed]
[10] Jia, X., Pendharkar, A.V., Loftus, P., Dodd, R.L., Chu, O., Fraenkel, M., et al. (2016) Utility of a Glucocorticoid Sparing Strategy in the Management of Patients Following Transsphenoidal Surgery. Endocrine Practice, 22, 1033-1039. [Google Scholar] [CrossRef] [PubMed]
[11] 张吉平, 郭清华, 母义明, 吕朝晖, 谷伟军, 杨国庆, 杜锦, 巴建明, 陆菊明. 230例中枢性尿崩症患者病因分布及临床特点分析[J]. 中华内科杂志, 2018, 57(3): 201-205.
[12] Burke, W.T., Cote, D.J., Iuliano, S.I., Zaidi, H.A. and Laws, E.R. (2017) A Practical Method for Prevention of Readmission for Symptomatic Hyponatremia Following Transsphenoidal Surgery. Pituitary, 21, 25-31. [Google Scholar] [CrossRef] [PubMed]
[13] Cooper, O., Lis, R., Bonert, V., Labadzhyan, A., Liu, N., Ben-Shlomo, A., et al. (2023) Fluid Restriction Reduces Delayed Hyponatremia and Hospital Readmissions after Transsphenoidal Surgery. The Journal of Clinical Endocrinology & Metabolism, 108, e623-e633. [Google Scholar] [CrossRef] [PubMed]
[14] Muskens, I.S., Zamanipoor Najafabadi, A.H., Briceno, V., Lamba, N., Senders, J.T., van Furth, W.R., et al. (2017) Visual Outcomes after Endoscopic Endonasal Pituitary Adenoma Resection: A Systematic Review and Meta-Analysis. Pituitary, 20, 539-552. [Google Scholar] [CrossRef] [PubMed]
[15] Fernandez-Miranda, J.C., Zwagerman, N.T., Abhinav, K., Lieber, S., Wang, E.W., Snyderman, C.H., et al. (2018) Cavernous Sinus Compartments from the Endoscopic Endonasal Approach: Anatomical Considerations and Surgical Relevance to Adenoma Surgery. Journal of Neurosurgery, 129, 430-441. [Google Scholar] [CrossRef] [PubMed]
[16] De Los Reyes, K.M., Gross, B.A., Frerichs, K.U., Dunn, I.F., Lin, N., Rincon-Torroella, J., et al. (2015) Incidence, Risk Factors and Management of Severe Post-Transsphenoidal Epistaxis. Journal of Clinical Neuroscience, 22, 116-122. [Google Scholar] [CrossRef] [PubMed]