Analysis of 35 cases receiving operation of the microsurgical resection of giant invasive pituitary adenoma via transcranial approach / 中国综合临床

ABSTRACT

Objective To explore the anatomy of optic microvascular and the transcranial microsurgicaloperative strategies for protection of optic nerve function during the operation of the resection of giant invasivepituitary adenoma.Methods Thirty-five patients with giant pituitary adenoma were treated by different surgicalapproaches according to preoperative imaging data.The tumors were removed by employing microsurgicaltechnique via the parachiasmal opticocarotid and carotidotentorial spaces in sellar region and by opening thelamina terminals.Much attention was given to the preservation of perforating arteries from the interal carotidartery,anterior and posterior communicating arteries and arterior choroidal artery to optic nerve and chiasmResults Total removal of tumors Was conducted in 25 cases.Subtotal removal was performed in 10cases.Anatomical preservation of the optic nerve was achieved in all the cases during the operation,with opticnerve function getting better in 20 cases,remaining unchanged in 2 cases,no improvement in 7 cases and gettingworse in 6 cases.Conclusion A reasonable surgical approach is a prerequisite for the giant invasive pituita~adenoma surgery.Understanding the anatomical characteristics of microvascular in the sellar region,carefulprotection of the optic nerve,optic chiasm and microvascular,skilled microsurgical technique during the operationis key to prevent post-operative complications of optic nerve function.