Endoscopic endonasal pituitary adenomas surgery for 138 consecutive patients

Abstract

Objective To study the surgical techniques and analyze the related factors affecting the tumor total removal and postoperative endocrinological remission for endoscopic endonasal pituitary adenomas surgery.Methods The cases of endoscopic endonasal pituitary adenomas surgery from March 2011 to August 2013 were retrospectively analyze.The endonasal approaches included the routine transnasal-sphenoidal approach,transnasal-maxillary sinus approach in 4 cases and transnasal-clivus approach in one case.Results According to the postoperative imaging data and endocrine examination results,the total removal of tumors was achieved in 108 patients (78.3％),and the endocrinological remission was achieved in 31 patients (44％) with functional adenomas.The serious postoperative complications included four cases of intracranial infection and one case of intracranial hemorrhage.Conclusions The tumor size and invasiveness of cavernous sinus were related to the total removal rate and endocrinological remission rate.The direction and degree of tumor invasion,and the surgeon's experience were the key influence factors of the endocrinological remission rate for invasive functional pituitary adenomas. Key words: Endoscope ; Pituitary adenoma; Endonasal approach