[Minimally invasive neurosurgery for removal of pituitary adenomas by neuroendoscope aided with sellar floor reconstruction].

Abstract

OBJECTIVE:

To evaluate the effect of surgical technique and clinical curative effect for a unilateral endonasal-transsphenoidal approach in the removal of pituitary adenomas (PAs) by an endoscope-assisted technique with sellar floor reconstruction.

METHODS:

Between April 2001 and March 2009, 426 consecutive patients underwent extended neuroendoscopic unilateral endonasal transsphenoidal surgery. The series consisted of 54 (12.7%) as I type of Pas and 105 (24.6%) II type, 181(42.5%) III type and 86 (20.2%) IV type according to Hardy's classification criteria of pituitary adenoma.

RESULTS:

Tumor removal, as assessed by intraoperative findings and postoperative magnetic resonance imaging or CT scans, revealed complete tumor removal in 370 cases (86.9%) and subtotal tumor removal in 32 cases (7.5%) were achieved. Partial removal was carried out in the remaining 24 cases (5.6%) with fibrous tumor. Three patients (0.7%) had postoperative death in this group. Twenty-four patients (5.6%) had a postoperative cerebrospinal fluid leak that required repair operations. Six patients (1.4%) experienced a sphenoid mucositis and meningitis and they were cured by medical therapy.

CONCLUSION:

The slightly soft texture of PAs with or without a limited suprasellar extension and without involvement of vascular structures, may be resected through such an extended neuroendoscopic transsphenoidal approach. Intraoperative angled endoscope is a useful adjunct for safe removals.

• Authors: Xiang Zhang, Zhou Fei, Jian-ning Zhang, Luo-an Fu, Wei-dong Cao, Yan Qu
• Journal: Zhonghua yi xue za zhi (Zhonghua Yi Xue Za Zhi) Vol. 90 Issue 33 Pg. 2342-4 (Sep 07 2010) ISSN: 0376-2491 [Print] China
• PMID: 21092494 (Publication Type: English Abstract, Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Female
• Humans
• Male
• Middle Aged
• Minimally Invasive Surgical Procedures
• Neuroendoscopy
• Pituitary Neoplasms (surgery)
• Plastic Surgery Procedures (methods)
• Sella Turcica (surgery)
• Young Adult