Clinical Efficacy Comparison Of Endoscopic Endonasal Transsphenoidal Extrapseudocapsular Resection And Routine Resection Of Pituitary Adenomas

Objective:To investigate the effects of extrapseudocapsular dissection technique on the tumor resection and endocrinological remission and postoperative complications in endoscopic transsphenoidal surgery for pituitary adenomas.Methods:Retrospectively analyzed the clinical data and follow-up results of 261 patients who underwent endoscopic transsphenoidal surgery for pituitary adenoma from June 2016 to December 2018 at Neurosurgery Department of the first affiliated Hospital of NanChang University.They were grouped according to the resection technique: 142 cases of the extrapseudocapsular resection group and 119 cases of the routine resection group.The total tumor resection rate,endocrine remission and complications of the two groups of patients were compared(P <0.05 was considered statistically significant).Results:The total resection rate of the extrapseudocapsular resection group and the routine resection group were 95.8%(136/142)and 89.1%(106/119),respectively.The difference was statistically significant(P = 0.038).The postoperative recurrence rate of the extrapseudocapsular resection group was lower than that of the routine resection group,2.1%(3/142)and 7.6%(9/119),respectively,the difference was statistically significant(P = 0.036).Compared with the routine resection group,the postoperative endocrine remission rate of functional adenomas in the extrapseudocapsular resection group increased,respectively,90.1%(50/55)and 63.2%(24/38),P = 0.001].However,there was no significant difference in the incidence of intraoperative and postoperative cerebrospinal fluid leakage(CSF),hypopituitarism,postoperative diabetes insipidus and intracranial infection between the two groups of patients(P> 0.05).Conclusion:Endoscopic transsphenoidal extrapseudocapsular resection of pituitary adenomas can increase the total tumor resection rate and endocrine remission rate of functional adenomas,lead a lower postoperative recurrence rate,it does not increase postoperative complications.