Clinical Application Analysis Of Endonasal Transsphenoidal Prolactinoma

Objective: Analysis the clinical effect of transsphenoidal surgery for prolactinomas, and investigate the influencing factors of the clinical effect.Method: We selected patients with prolactinomas that were underwent transsphenoidal surgery and treated in Chinese-Japan Union Hospital of Jilin University from September 2004 to December 2007. 48 cases have been choosed. And clinical data of the 48 cases were analyzed retrospectively. Of the 48 cases, 4 were male and 44 were female. Age at presentation of GC ranged from 23 years to 67 years. The diameter of the lesions ranged from 4.6 to 13.5cm (average, 6.2cm). 9 cases were treated by bromocriptine before surgery. The level of prolactin are as follows: < 100μg/L, 15cases, 100-200μg, 19cases, >200μg/L, 14 cases.All the patientsunderwent MRI on a Siemens 1.5 Tesla machine. The following sequences were performed: T2-weighted sequences, and gradientecho T1-weighted sequences before and after gadolinium injection. All the 48 cases were confirmed by histological examination. The index we oberserved and analysis included: the extent of tumor resection, the rate of symptom remission, decline level of prolactin, complication after surgery,rate of recurrence.Results: The total removal was achieved in all the 48 cases. The cure rate of amenorrhe was as follow: prolactin<100μg/L, 66.7 % ;100-200μg, 66.7; > 200μg/L, 14.7%. There was no significantly different (Z>0.05) between the three groups. There was also no significantly different between the two group that treated by bromocriptine before surgery and not.Conclusion: 1. transsphenoidal surgery is a efficient method for prolactinomas. It is mimalinvasive, deserving clinical expansion. 2. The level of prolactin is a important factor that affect the clinical effect of transsphenoidal surgery for prolactinomas. 3. Whether treated by bromocriptine before surgery or not have no effect on the clinical effect of transsphenoidal surgery for prolactinomas. 4. The prognosis is not favalable for patients with invasive prolactinomas.