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目的 探讨一种改良双侧额下入路切除巨大鞍区肿瘤的可行性。方法 分别采用超低双侧额下入路(超低组)及传统单侧额下入路(传统组)切除巨大鞍区肿瘤40例,将手术疗效及并发症发生情况进行对比分析。结果 超低组大型肿瘤(2cm≤直径<4cm)10例,全切除9例、次全切1例;传统组7例,全切5例,次全切2例。超低组巨型肿瘤(4cm≤直径)15例,全切4例,次全切11例;传统组8例,次全切5例,部分全切3例,无1例全切。超低组的术后症状改善、并发症发生、肿瘤复发等方面均优于传统入路组。结论 超低双侧额下入路显露充分,切除率高,并发症少,复发率低,对于适合额下入路的巨型鞍区肿瘤的治疗优于传统的单侧额下入路。
Objective To explore the feasibility of a modified double inferior frontal approach for resection of giant sellar tumors. Methods Forty cases of tumors in giant saddle region were resected by using ultra-low bilateral inferior frontal approach (ultra-low group) and conventional unilateral inferior frontal approach (traditional group), respectively. The curative effect and complication were compared and analyzed. Results In ultra-low group, 10 cases of large tumors (2cm≤diameter <4cm), 9 cases of total resection and 1 case of subtotal resection. There were 7 cases in traditional group, 5 cases of complete resection and 2 cases of subtotal resection. There were 15 cases of ultra-low giant tumor (4cm≤Diameter), 4 cases of complete resection and 11 cases of subtotal resection. There were 8 cases of conventional group, 5 cases of subtotal resection, 3 cases of partial resection and 1 case of complete resection. Ultra-low postoperative symptoms, complications, tumor recurrence and other aspects are superior to the traditional approach group. Conclusion Ultra-low bilateral inferior frontal approach is well exposed, with high resection rate, fewer complications and low recurrence rate. It is superior to the traditional unilateral inferior frontal approach for the treatment of giant sellar tumors suitable for inferior frontal approach.