Abstract: Objective　To investigate the clinical efficacy and safety of extended endplate approach for microsurgical resection of craniopharyngioma inside and outside the suprasellar third ventricle. Methods　The clinical data of 38 cases of craniopharyngioma, including 22 males and 16 females, who underwent extended endplate approach microsurgery for suprasellar third ventricle were retrospectively analyzed. Imaging data suggested that 14 cases were simple cystic disease, 12 cases were simple substantive disease, 12 cases were cystic solid disease, and 15 cases were tumor with calcification indicated by CT. Preoperative and postoperative imaging data, hormone levels, visual field and pathological results were collected. Results　Among the 38 patients, 34 patients (89.5%) received total resection through extended endplate approach, 3 patients (7.9%) received subtotal resection and 1 patient (2.6%) received partial resection. There were no surgery-related deaths. Thirty-one patients showed improved visual acuity or had no change within 1 month after operation. Postoperative follow-up was (54.5±7.3) months, 4 patients had tumor recurrence, including 2 patients who received re-operation and 2 patients who received radiotherapy. Conclusion　Extended endplate approach for microsurgical resection of craniopharyngioma in and out of the third suprasellar ventricle has a high total resection rate, fewer postoperative complications and is beneficial to the protection of pituitary stalk optic nerve.

Key words: craniopharyngioma, third ventricle, microsurgery, surgical approach, trans-lamina terminalis