Analysis Transsphenoidal Surgery Efficacy Prolactinomas

Background and ObjectiveProlactin is a hormone-secreting pituitary adenoma adenoma is the mostcommon form, accounting for40%-60%. Prolactinomas more common in youngpeople aged20-30, women were significantly more than men. Tumor mass effect andassociated adenoma pituitary hormone hypersecretion, will lead to a series of clinicalsymptoms in patients with endocrine disorders, and neurological disorders, seriouslyaffect this quality of life of the patients and may be life threaten. So the correctdiagnosis and the treatment of pituitary adenomas are necessary. Current the clinicalstudy of pituitary adenomas are more activity, especially in this treatment ofprolactinomas choice, two major types of surgery and drug therapy perspective.Pituitary adenoma tumor size in patients with prolactin herein, growth patternsand preoperative serum prolactin level of classification, based on an assessment of thesurgical treatment of postoperative serum prolactin levels, by summarizing raisedifferent types of prolactinomas Recognizing surgery, providing some guidance forclinical treatment. MethodsA retrospective analysis of the complete data from October2009to December2013at the First Affiliated Hospital of Zhengzhou University, Department ofNeurosurgery performe transsphenoidal microsurgical the treatment of130cases ofthe patients with prolactinomas and conduct follow up. According to the tumor size,growing patterns, preoperatives the prolactin levels, whether the application ofpreoperative and postoperative imaging drugs such as classification, according to thepostoperative serum prolactin levels were evaluated for surgery. All the informationinto the computer for statistical analysis using SPSS17.0statistical software toanalyze these data.ResultsTranssphenoidal pituitary adenoma resection of130patients underwent amicroscope. Total resection in90patients(69.23%), subtotal in25patients (19.23%),partial resection in15patients (11.54%). Adenoma in35patients, total resection in35cases, total removal rate of100%; macroadenomas75patients,50cases of totalresection of the tumor, total removal rate of approximately66.7%; huge adenoma in20patients, tumor removal five cases, the full cut was25%; micro adenomasgreater than the full cut large adenomas and adenomas huge difference wasstatistically significant (p<0.05); non-invasive adenomas75cases, total resection in65cases, full cut rate of about86.7%; invasive adenoma55cases, total resection in25cases, total removal rate of about36.4%.non-invasive adenomas greater than totalremoval of invasive adenomas, the difference was statistically significant (p<0.05).Serum PRL levels <100ng/ml group and remission rates100~200ng/ml comparisongroup, the difference was not statistically significant (p>0.05); serum PRL levels<100ng/ml and>200ng/ml surgical treatment group response rate In contrast, thedifference was statistically significant (p<0.05). Adenoma endocrine remission rateafter more than a large adenomas and adenomas huge difference was statisticallysignificant (p<0.05). Non-invasive and invasive adenoma adenoma surgical remissionrate comparative analysis, the difference was statistically significant (p<0.05). Most patients with postoperative serum prolactin levels to normal, clinical symptoms havebeen alleviated. A few patients had transient diabetes insipidus, cerebrospinal fluidleakage and other complications.Conclusions1、endocrine remission rates in patients with postoperative tumor size, andwhether the pre-invasive preoperative serum PRL levels.2、transsphenoidal surgery for total removal rate of adenoma and non-invasiveadenomas, endocrine remission rate after surgery is good, and for the non-invasivemicro-adenoma adenoma recommend this surgical.3、transsphenoidal surgery for invasive macroadenomas and invasive adenomassurgery huge difference.