Pituitary adenoma resection by single-nostril transsphenoidal approach / 中华显微外科杂志

ABSTRACT

Objective To summarize the experience of pituitary adenoma resection by single-nostril transsphenoidal approach and analyze the indications,intraoperative and postoperative common problems in order to improve the technique and quality of life.Methods Summarize the clinical data of 611 pituitary adenoma resections by single-nostril transsphenoidal approach from January 2005 to June 2010 retrospectively,reanalyze the choice of operative indications,analyze the bleeding during the operation and sums up the relevant pro cessing suggestions,and summarize the reasons and countermeasures of postoperative visual impairment.Results The tumors were totally removed in 538 cases,sub-resections in 59 cases,sub-totally removed in 14 cases,and no deaths.Eleven cases were poor gasification or concha sphenoid sinus in 11 totally removed patients.The bleeding came from diploe,emissarium,mucosa of sphenoid sinus,diploe,epidural space,dura matter of the sella turcica region,intercavernous sinuses,tumor or the tumor bed.The bleeding was controlled effectively with different approaches.There were 3 patients who underwent visual impairment,and the impairment was improved after treatment.Conclusion Following the correct operation principle,we can improve the rate of total resection; the single-nostril transsphenoidal approach is also suitable for the poor gasification; The prognosis can improve after deal with the intraoperative and postoperative common problems.