Endoscopic Transsphenoidal Approach For Treatment Of Pituitary Adenomas

Objectives To explore the efficacy and safety of neuroendoscopic transsphenoidal approach for pituitary adenoma,and to analyze the surgical complications of neuroendoscopy,and to summarize the surgical experience of neuroendoscopic surgery for pituitary adenoma.Methods A retrospective analysis of the clinical data of 60 patients with pituitary adenoma who underwent transsphenoidal neuroendoscopic surgery in the People’s Hospital of Hebei Province from August 2014 to 2017 was classified according to tumor size: huge There were 6 cases of adenoma;40 cases of large adenoma and 14 cases of microadenomas.According to the function classification: 22 cases of non-function pituitary adenoma;16 cases of prolactin-secreting pituitary tumor(PRL);8 cases of thyroid-stimulating pituitary adenoma(TSH);9 cases of adrenal cortex-type pituitary adenoma(ACTH);Five cases of mixed pituitary adenoma were secreted.The degree of tumor resection and the incidence of intraoperative or postoperative complications in 60 cases of transsphenoidal pituitary adenoma were analyzed.The methods and techniques of this procedure were summarized and the patients were operated for 6-52 months.Follow-up,an average of 18.6 ± 3.2 months.Results In this study,60 patients with pituitary adenoma were treated with total tumor resection in 46(80%),subtotal resection in 10(16.7%),partial resection in 4(3.3%),and clinical improvement in 52(86.7%).Postoperative hormone levels returned to normal in 30 cases(30/38,78.9%),decreased in 3 cases(3/38,7.9%),and no improvement in 5 cases(5/38,13.2%).Eight patients with pituitary tumor surgery had postoperative complications,including cerebrospinal fluid rhinorrhea,diabetes insipidus,hypopituitarism,and olfactory disturbance.During the follow-up,15 patients had recurrence,7 underwent reoperation,and 8 underwent gamma knife treatment.Statistical analysis was performed according to the tumor size included in each endocrine function type of the patients.Conclusions Endoscopic transsphenoidal surgery for pituitary adenoma has a clear curative effect,high total tumor resection rate,less intraoperative and postoperativecomplications,less invasion of normal anatomical structures during surgery,and is currently the first line of treatment for pituitary tumors.treatment method.Figure 0;Table 1;Reference 124...