Theoretically, craniopharyngioma is a benign intracranial tumor, and complete surgical resection can achieve the possibility of cure. However, because the tumor involves the hypothalamus structure and is located in the deep brain structure, it is a tumor that is difficult to be removed surgically. Due to the development of microscopic neurosurgery technology in recent years, most of the tumors can be completely resected (more than 90%), and progress has been made in the treatment of postoperative complications of hypothalamic functional impairment, such as control of postoperative uremia, correction of electrolyte disorders and replacement therapy of anterior pituitary hormone. Patients can fully return to normal status after surgery. In terms of current surgery for total craniopharyngioma resection, it means that all the tumors seen are removed under the operating microscope, and early postoperative cranial CT and MR imaging is done to prove that no tumor remains. In contrast, in the 10-year follow-up of patients after total tumor resection, data reported that 10-18% of patients still had tumor recurrence, indicating that surgical total resection of craniopharyngioma only refers to clinical histological removal of tumor, not to complete eradication of tumor biocytologically. The characteristics of tumor recurrence observed by imaging are: 1. 37% of tumor recurrence sites are within the saddle diaphragm, indicating that some suprasellar tumors enter the saddle through the saddle diaphragm foramen; 2. 19% of tumor recurrence is located in the pituitary stalk or the bottom growth of the third ventricle of the funnel; 3. 5% of recurrence tumors are located in the optic nerve and optic cross; 4. 3% of recurrence is located in the third ventricle; 5. 36% of recurrence tumors are recurred because of untimely follow-up, or recurrence The tumors were too large to determine the site of recurrence. In some of these tumors, postoperative residuals are due to the inexperience of the surgeon or due to the toughness of the tumor or the accumulation of its surrounding structures. For recurrent tumors, theoretically, adhesions between the residual tumor and surrounding structures and unclearness of the residual tumor and surrounding structures after the previous surgery will make the second surgery to remove the tumor more difficult and decrease the total resection rate. Surgical resection of recurrent craniopharyngioma is still the best choice For the treatment of recurrent tumors, there are various methods in the past, such as intra-tumor radiotherapy, external radiotherapy and gamma knife treatment, in addition to secondary surgical resection. Gamma knife treatment is mostly suitable for recurrent tumors less than 2.0 cm in diameter that are solid and not compressing the optic nerve, optic cross and hypothalamus. Both internal and external radiotherapy and gamma knife treatment cause the risk of damage to important structures around the tumor, and cystic tumors have the ability to absorb gamma rays and are insensitive to the tumor. Therefore, the methods of external and internal radiotherapy and gamma knife for recurrent tumors have certain limitations. From our surgical resection of nearly 280 cases of craniopharyngioma, we should strive to achieve complete resection of the tumor for patients with initial surgery to maximize the prevention of tumor recurrence. For patients with tumor recurrence after surgery, under the condition of protecting the hypothalamus structure, the majority of patients can also achieve total tumor resection. The importance of complications after secondary surgery More importantly, it should be noted that the complications such as polydipsia and polyuria after recurrent craniopharyngioma are often more serious than those after the first tumor resection. However, they can mostly be corrected with close observation of the condition and timely correction. Adrenocorticotropic hormone deficiency, especially adrenocorticotropic hormone (ACTH) deficiency, is often more severe, when patients have weakness, mental weakness, drowsiness and urinary incontinence. Some postoperative patients often require longer-term replacement therapy with ACTH or adrenocorticotropic hormone.