Abstract
The purpose of this study is to demonstrate the benefits of and to relate our experience with endoscopic-assisted transsphenoidal surgery of pituitary tumors. From 1999 to 2007, 103 patients (61 male, 42 female) ranging in age from 21 to 76 years old (median, 48 years) with sellar tumors were treated at the Brazilian Air Force Hospital and Hospital Universitário Antonio Pedro. The patients were placed in the supine position with the head turned toward the neurosurgeon. The tumors were removed through a binostril transnasal direct approach using a 4-mm rigid 0- and 300-degree endoscope without working channel. Hemostatics were used to pack the sellar floor. Two-stage surgery was performed in 21 patients with giant adenomas. Chiasmatic decompression was achieved in the majority. Sixty-seven patients had macroadenomas and 36 microadenomas (69 nonfunctioning tumors, 17 GH-hormone secreting, 10 adrenocorticotropic tumors, and 7 nonpituitary tumors). Eleven of 17 acromegalic patients had resolution of their symptoms. Six patients developed CSF leak, four of them treated with subarachnoid lumbar drainage, and two required reoperation. Endoscopic transsphenoidal surgery provides a fast and safe approach to the sella, improves the surgical view, and has become our first option to reach sellar tumors.
Published Version
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