Diagnosis And Treatment Of Pituitary Adenomas (Analysis Of 120 Patients Of Pituitary Adenomas)

Objective: The aim of this study was to discuss the characters of pituitary adenomas, to analysis the advantage and disadvantage between direct transnasal transsphenoidal approach and trans- cranial approach for 128 cases of pituitary adenomas and to report the results in terms of tumor remission, improvement in vision and compli- cations.Methods: Our prospectively recorded surgical database was searched from January 1st, 2006 to December 31st, 2007 in the First Hospital of Jilin university. We choosed 128 cases, which had been diagnosed as pituitary adenomas by pathology. Those patients who had surgery had their medical charts reviewed and presenting symptoms and signs, lesion characteristics, endocrine investigations, operative details, complications, and treatment outcomes recorded. 108 of them have received the direct transnasal transsphenoidal approach surgery and 20 pituitary adenomas of them received transcranial operation. Two groups are compared on surgery time, effect after operation, the complications and so on.Results: 128 patients were included in the study. 37 patients (28.9%) belonged to Gradeâ… , 39 patients(30.5%) belonged to Gradeâ…¡, 22(17.2%)â…¢, 16 patients(12.5%) belonged to Gradeâ…£, 14 patients(10.9%) belonged to Gradeâ…¤according to the tumor's size. Most patients of gradeâ…¢-â…¤had significant supra- or parasellar extension. 70 of the patients(54.7%) who had visual loss at presentation, most of them had postoperative improvement. There was no case of death among 128 patients. The rate of total excision was about 98.1% in the transsphenoidal group, while the rate about 55.0% in the transcranial group. The postoperative complications of the transsphenoidal group was more little and simple than the transsphenoidal group, and was dealed easily.Conclusion: The advantages of transsphenoidal approach had small trauma, little bleeding, needs short time for operation. Postop- erative applications was few. The expense of operation was reduced. And complete excision rate was high. The rates of morbidity and mortality were extremely low. The exposure of transcranial approach was better, could prolong the operative cut according to the informations of operation. Both approachs had advantages and disadvantages. They were supplementary for each other.