The Minimally Invasive Surgical Treatment Of Pituitary Adenomas In Elderly Patients

Objective： To study the single-center clinicalcharacteristics, diagnosis and minimally invasivesurgical treatment of pituitary adenomas as well asexplored the safety and efficacy of the transsphenoidalsurgery in elderly patients.Methods：A retrospective analysis was performed usingclinical data of21elderly patients over the age of60undergoing transsphenoidal surgery in157pituitaryadenomas patients who were treated in the firstdepartment of The China-Japan Union Hospital of JilinUniversity from July2009to October2012.Results：In the21elderly patients,the average age was65.52years(range60.2–76.5).9patients were men and12were women.14patients presented with vision changes,10patients with visual field defects,7patients withheadache. After transsphenoidal surgery,71.4%patientswith symptoms of headache and70%patients with the visualchanges improved significantly,1patient died inperioperative period.The average follow-up period was16.1 months.14of the18cases evaluated by MRI were notrecurrent during the follow-up, while1case needed to takeoral administration of bromocriptine as a result ofprolactin increase, There were not any serious short andlong term complications after surgery.Conclusions：Elderly patients with pituitary adenomas aremainly non-functioning adenomas, mainly presented withvisual and visual field changes, may be no obvious symptomssuch as headache and endocrine changes. Vision and visualfield changes are often the main reason for patient visits.Vision impairment is one of the surgical indications ofelderly patients with pituitary adenomas. Visionimprovement effectively is the main purpose of the surgery.As a minimally invasive treatment, with adequatepreoperative preparation, sophisticated operation andwell perioperative management, transsphenoidal surgery issafe and effective, and has been as one of the preferredtreatment of elderly pituitary adenoma patients.