Correlation Between Neuroendoscopic Transsphenoidal Extrapsular Resection Of Pituitary Adenoma And The Recovery And Recurrence Of Pituitary Function

Objective: To evaluate the effect of neuroendoscopic transnasal transsphenoidal approach in the treatment of pituitary adenoma?Methods:From June 2018 to December 2018,48 cases of randomly selected pituitary adenomas were treated by neuroendoscopic transnasal transsphenoidal approach in our hospital,among which 26 cases were treated by neuroendoscopic transnasal transsphenoidal pseudocapsule resection and 22 cases were treated by neuroendoscopic transnasal transsphenoidal pseudocapsule resection.All subjects underwent preoperative imaging,laboratory and ophthalmic examinations.Neuroendoscopic transnasal transsphenoidal approach was adopted for the operation.If the tumor was found to be completely surrounded by thick and tough pseudocapsule during the operation,the tumor was extricated and removed along the pseudocapsule.If the false capsule is incomplete or thin and the tumor is large,the tumor should be carefully identified and removed after intracapsular resection.Postoperative follow-up was conducted to review pituitary MRI and hormone levels.Preoperative hormone levels,postoperative day 1,postoperative day 3,and postoperative hormone levels were compared between the two groups.Postoperative symptom remission and related complications were compared between the two groups.The pituitary MRI enhancement + plain scan after half a year was compared between the two groups.Results:In this study,the total tumor resection rate outside the pseudocapsule was 88.4%,and the total resection rate inside the pseudocapsule was 68.1%,P=0.039 < 0.05,which was statistically significant.The rate of endocrine remission and symptom recovery of pituitary adenoma in the sham extrapsular resection group was 92%,significantly higher than that in the intrapsular resection group(68.1%),P=0.049,which was statistically significant.The rate of cerebrospinal fluid leakage was 11.5% in the operation.The rate of false intracapsid cerebrospinal fluid leakage was 4.5%,with no statistically significant difference.After reconstruction,the rate of false extracapsid cerebrospinal fluid leakage was 3.8%,with no statistically significant difference.Postoperative diabetes insipidus was 23% and 31.8%,respectively.The difference was not statistically significant.Conclusion:Neuroendoscopic transsphenoidal extrapsular resection of pituitary adenoma can maximize the degree of resection,reduce the damage to the normal pituitary gland,improve the recovery of endocrine function,and do not increase the incidence of postoperative complications.