The Influencing Factors Analysis Of Resection Degree Of Invasive Pituitary Adenoma Treated With Endoscopic Endonasal Transsphenoidal Approach

BackgroundAs a common intracranial tumor,pituitary adenoma grow generally slowly and its histological origin is from anterior pituitary(adenohypophysis).In the clinical treatment,the surgical result of invasive pituitary adenoma is not very ideal,duing to its close relationship with peripheral blood vessels,nerves and tissues.With the development of neurosurgery,especially in modern times,the invention of advanced equipment and surgical methods,the emergence of micro-neurosurgery and the clinical application of neuroendoscopy have provided great convenience for the treatment of invasive pituitary adenoma.More and more studies have confirmed that neuroendoscopy has become the first choice for the treatment of invasive pituitary adenoma in recent years,because of its clearly surgical view,widely visual angle,small invasiveness,safety,efficacy and rapid recovery.During the treatment of patients with invasive pituitary adenoma,preoperative evaluation and intraoperative judgement of the resection degree are particularly important for the later therapy.This paper studies the influencing factors of the extent of resection and methods to improve it,and provide a basis for the prediction of the resection degree of invasiv pituitary adenoma,which can assist surgeons to prepare preoperative evaluation and intraoperative operation.ObjectiveTo analyze the influencing factors of the resection degree of invasive pituitary adenoma treated with endoscopic endonasal transsphenoidal approach,and provide a basis for predicting the resection degree of invasive pituitary adenoma.MethodsCollected patients with invasive pituitary adenomas who were admitted to the First Affiliated Hospital of Zhengzhou University during 2016-09--2019-06.To retrospectively analyze patients with different gender,age,tumor Knosp grade,invasion side of cavernous sinus,volume,location,texture and postoperative resection degree.Univariate analysis was performed on the variables influencing the resection degree of invasive pituitary adenoma,and the variables with statistical significance were analyzed by Logistic regression.ResultsStatistical results showed that Knosp grade,invasion side of cavernous sinus,volume,location and texture are risk factors for resection degree,while Knosp grade,size and texture are independent risk factors for the degree of resection.Conclusions1 The resection degree of invasive pituitary adenoma treated with transsphenoidal neuroendoscopy is related to the Knosp grade,single or bilateral invasion,volume,location,and texture.Tumors with higher Knosp grade,larger tumor volum and tougher texture,the resection degree of them are lower.2 Analysis of tumor grading and volume according to the imaging findings,application of skills and assistive techniques can improve the resection degree.