The Microsurgical Treatment Of The Large Pituitary Adenomas And The Giant Pituitary Adenomas

Objective To discuss the microsurgical outcome and operative technique oflarge,giant pituitary adenomas treated. Methods In our series there were 234 cases of large pituitary adenomasand 118 cases of giant pituitary adenomas . 298 pituitary adenomas have beentreated microsurgically by frontal approach , 54 pituitary adenomas have beentreated microsurgically by supraorbital key hole approach . 197 patient werereceived radiotherapy postoperatively Results The large pituitary adenomas were totally resected in 231 cases ,subtotally resected in 3 cases . The giant pituitary adenomas were totallyresected in 111 cases, subtotally resected in 7 cases. 289 patients werefollowed-up (mean duration : 4.07 years) ,including image, endocrinic, sight,vision field and so on. Totally removal rate was 98.5% in large pituitaryadenomas , 94.06% in giant pituitary adenomas. Recurrency were found in 17patients after operation , recurrence rate was 4.86%. The hormone level wasgreatly reduced postoperatively. Conclusions In the basis of very familiar sella anatomy, the large, giantpituitary adenomas was resected through frontal approach or supraorbitalkeyhole approach , the operative space was between subdual and epiarachnoid .Under the microscope, border of tumor and its capsule could be found andenlarged step by step . Tumor was removed piece by piece and could beremoved totally. the outcome was satisfied.