ENDOSCOPIC TRANSSPHENOIDAL PITUITARY SURGERY
Autori:
Ante Melada, Ranko Mladina, Ivan Škoro
Sažetak
Sažetak. Endoskopske operacije prakticiraju se u našoj klinici od 1996. godine kao pripomoć u mikroneurokirurškim operacijama. Na sličan način upotrebljavao se i endoskop u transsfenoidalnoj hipofiznoj kirurgiji, ali od početka 2004. godine počeli smo operirati tumore hipofize potpuno endoskopskim putem. Želimo prikazati svoja iskustva kod prvih devedeset pacijenata, kao i svoju operacijsku tehniku. Endoskopska hipofizna kirurgija radi se kroz nosnicu bez incizije kože. Četirimilimetarski endoskop uvodi se kroz nosnice u sfenoidalni sinus i tumor se uklanja specijalno dizajniranim kirurškim instrumentima. Postoperacijska je njega minimalna i bolesnici su otpuštani kući treći postoperacijski dan. Prva kontrola je mjesec dana nakon operacije. Imali smo osamnaest recidiva tumora.
Summary
Summary. Endoscopic surgery has been performed in our Department since 1996 as assistance in micro-neurosurgical procedures. In the same way the endoscope was used in transsphenoidal pituitary surgery, but from the beginning of 2004 we started with »pure« endoscopic surgery. We present our experience with the first ninety patients to demonstrate our way of operating. Endoscopic pituitary surgery is performed through a natural nasal air pathway without any incisions. A 4-mm endoscope is placed in front of the tumor in the sphenoidal sinus and the tumor is removed with specially designed surgical tools. Postoperative nasal packing is not necessary and postoperative discomfort is minimal so the hospital stay lasts 3 days. The first control was after one month. There were eighteen recurrences of tumors.
