Application Of Neuronavigation In Transsphenoidal Resection Of Complex Pituitary Adenomas

Objective:By comparing the operation time,intraoperative blood loss,postoperative hormone return to normal rate,and tumor resection of the two groups of patients who underwent conventional transsphenoidal resection of complex pituitary adenomas and neuronavigation transsphenoidal resection of complex pituitary adenomas.Analyze the advantages and disadvantages of the application of neuronavigation in transsphenoidal complex pituitary adenoma resection,including whether postoperative cerebrospinal fluid leakage,intracranial infection,postoperative diabetes insipidus,etc,and provide certain reference value for the clinical treatment of patients with transsphenoidal complex pituitary adenoma.Methods:A retrospective analysis of patients with complex types of pituitary adenomas with abnormal sphenoid sinus dysplasia or aggressive tumors admitted to the Department of Neurosurgery of the Second Affiliated Hospital of Kunming Medical University from July 1,2019 to November 30,2020,a total of 32 cases,all Transsphenoidal pituitary adenoma resection was performed.Organize medical records and divide them into control group and study group according to whether the neuronavigation is applied or not.The control group is the conventional transsphenoidal complex pituitary adenoma resection group with 18 patients;the research group is under the neuronavigation transsphenoidal complex pituitary adenoma resection group,there were 14 patients.The two groups of patients were compared and analyzed the operation time,intraoperative blood loss,postoperative hormone return to normal rate,degree of tumor resection,whether postoperative cerebrospinal fluid leakage,whether intracranial infection,whether postoperative diabetes insipidus and other indicators;using SPSS 26.0 statistical software,Statistical methods such as t test,chi-square test,Wilcoxon rank sum test,and multiple linear regression were used for statistical analysis of the data.P<0.05 indicates that the difference is statistically significant.Results:1.Comparing the distribution of the two groups of patients in terms of gender,age,operation methods,and complex types of pituitary adenomas,the P values were 1,0.086,0.703,and 0.075,respectively,which were all greater than 0.05,and the difference was not statistically significant.2.Compared with the operation time,the operation time of the conventional operation group is longer than neuronavigation operation group(209±80.123min VS 156.29±45.374min),t=2.198,P=0.036,the difference is statistically significant;3.Intraoperative blood loss comparison,the blood loss during the operation in the conventional operation group was greater than that in the neuronavigation operation group(175±100ml VS 100±38ml),Z=-2.152,P=0.031,the difference was statistically significant;4.Comparison of total surgical removal rate,conventional operation group is lower than the neuronavigation operation group(50%VS 57.1%),P=0.735,the difference is not statistically significant;5.Comparison of the postoperative hormone return to normal rate,the conventional operation group postoperative hormone recovery rate is lower than the neuronavigation operation group(56.3%VS 60.0%),P=1,the difference was not statistically significant;6.Compared with the postoperative intracranial infection rate,the postoperative intracranial infection rate in the conventional operation group was higher than that in the neuronavigation surgery group(27.8%VS 14.3%),P=0.426,the difference was not statistically significant;7.Compared with the incidence of postoperative diabetes insipidus,the conventional surgery group was higher than that in the neuronavigation surgery group(27.8%VS 21.4%),P=1,the difference was not statistically significant;8.Compared with the incidence of postoperative cerebrospinal fluid leakage,the probability of postoperative cerebrospinal fluid leakage in the conventional operation group was higher than that of the neuronavigation operation group(22.2%VS 14.3%),P=0.672,there is no statistical difference.Conclusion:The accurate positioning of the neuronavigation system can shorten the operation time,reduce the amount of intraoperative blood loss,and is convenient and quick to use.In clinical work,patients with abnormal sphenoid sinus development and aggressive pituitary adenomas can be used as a more effective way to perform transnasal sphenoid surgery.