目的 探讨复发颅咽管瘤显微手术切除的入路及手术技巧.方法 回顾性分析2007年3月—2017年3月苏州大学附属第一医院经显微手术切除的31例复发颅咽管瘤患者的临床资料、手术入路、手术技巧、疗效和术后并发症.翼点(改良翼点)入路16例,眶上外侧入路6例,纵裂胼胝体入路5例,联合入路3例,额下入路1例.术后随访复查头颅CT及MRI增强扫描.结果 肿瘤全切除27例(87.1％),次全切3例(9.7％),大部分切除1例(3.2％).术后电解质紊乱27例,垂体功能低下5例,视力减退1例.围手术期死亡1例,复发4例.垂体柄完整保留23例,部分保留3例,切断3例,不能鉴别2例.结论 复发颅咽管瘤显微手术并发症多,但仍是根治颅咽管瘤的有效方法.“,”Objective To study the surgical approaches and surgical skills of microsurgical resection of the recurrent craniopharyngiomas. Methods We reported 31 cases of recurrent craniopharyngiomas that were treated surgically from March 2007 to March 2017 at our hospital. 31 cases of recurrent craniopharyngiomas undergoing microsurgical resection via various approaches were retrospectively analyzed. The resection were performed via pterional approach (n=16), lateral supraorbital approach (n=6), transcallosal (n=5), combined (n=3), subfrontal approach (n=1). During follow-ups, they were monitored for residual or recurrent tumor by postoperative contrast computed tomography (CT) and magnetic resonance imaging (MRI). Results The removals of lesions were total (n=27, 87.1％), subtotal (n=3, 9.7％) and partial (n=1, 3.2％). There were 1 case of visual deterioration, 27 cases of electrolyte disturbances, 5 cases of hypopituitarism, 1 case of death. After microsurgical resection, there were 4 cases of relapse. And 23 cases had an intact preservation of pituitary stalk, which partially preserved in 3 patients, severe in 3 cases, and unidentified in 2 cases during surgery. Conclusion Microsurgery can still be an efficacious therapeutic option in the management of recurrent craniopharyngiomas, although the reoperation of the tumors has more complications.