Follow-up And Analysis Of Transsphenoidal Microsurgery Of Pituitary Adenomas

Objective: to assess the outcome of transsphenoidal microsurgery.Methods: Transsphenoidal microsurgical operation were performed in 118 cases of pituitary adenomas. All patients were followed up from 6 months to 3 years after surgery. 51 patients were women and 67 patients were men(age of 18～74 years). All the operations were performed by Prof, Xian Rui Yuan at the department of neurosurgery in Xiang-Ya hospital from January 2003 to March 2006.Results: none of the 118 patients had severe complications afer operation and no death in this group. Symptoms improved after operation in 93/118 cases (78.8%) , 25/118 cases (21.2%) had no improvement. Vision and field of vision improved after operation in 76/92(82.6%) cases, 2/92(2.2%)cases worse .there were 65 casess of large adenoma, 39 casess of giant adenoma, and 21 cases of micro-adenoma, the total resection rate was71/118 (60.2%). The rate of improvement of the level of serum prolactin was 39/68 (57.4%),and the improvement rate of the level of serum growth hormone was 11/23 (47.8%).No case had recurrence of the follow-up for 3 years in the full resection group. Among the subtotal resection 36 cases, 16 cases received radiotherapy,and the other 20 cases without , Each groups had 1 case of recurrence. Conclusions1. Among the 118 cases, there were 21 cases of micro-adenoma,65 cases of large adenoma,33 cases of giant adenoma . There were 71 cases(60.2%) of full resection,27cases (22.9%) of subtotal resection,19 cases (16.1%) of partial resection. No death case ,2. Symptoms improved after operation in 93/118 cases (78.8%) , 25/118 cases (21.2%) had no improvement . Vision and field of vision improved after operation in 76/118(64.4%) . The rate of improvement of the level of serum prolactin was 39/68 (57.4%),and the improvement rate of the level of serum growth hormone was 11/23 (47.8%).3. No case had recurrence of the follow-up for 3 years in the 71 full resection cases. Among the 36 subtotal ( or partial resection ) cases, 16 cases received radiotherapy,and the other 20 cases without , each groups had 1 case of recurrence.4. Study shows transsphenoidal microsurgery of pituitary adenoma is safe, efficient ,with less complications.5. Compared to internal and abroad reports ,the outcome of the operation is better.