Endoscopic endonasal transsphenoidal surgery in treatment of pituitary adenoma: Experience with 46 patients / 第二军医大学学报

ABSTRACT

Objective: To introduce our experience on endoscopic endonasal transsphenoidal surgery in 46 patients with pituitary adenomas. Methods: Forty-six patients (27 females and 19 males) with a median age of 39 years (range 22-73 years) were enrolled in this study. MRI or CT images showed that the diameters of the tumor were 3 cm in 8. Thirty-five patients had hormone-secreting adenomas and 11 had non-secreting ones. All patients received endoscopic endonasal transsphenoidal (absence of the transsphenoidal retractor) resection of the tumors and neuronavigation system was used in 3 cases. Results: Total tumor resection was achieved in 35 patients, subtotal in 6 and partial in 5. The operative time was from 1 to 3.5 hours. The postoperative hospitalization time was averagely 4.6 days (from 3 days to 10 days) and there was no operative death or optic nerve injury in our group. During follow-up (1 month to 3.3 years), 21 of the 23 patients with eyesight problems had their visual acuity improved and 24 of the 32 patients with abnormally high levels of hormones had their hormones restored to the normal levels. Two patients received γ-knife surgery after operation and 18 cases received radiation therapy 3 months after operation. Recurrence was found in 1 patient with MRI 1 year later and received neuronavigation-assisted endoscopic reoperation again. Conclusion: The method in this paper, with less operative trauma and complication, provides a satisfactory deep illumination and a panoramic operative field; moreover, it brings us more close to the operative target. All these factors contribute to the rapid recovery of patients.