Surgical treatment of pituitary adenomas via endoscopic transsphenoidal approach: a clinical analysis of 39 cases

Abstract

Objective To evaluate the indications and the surgical technique of endoscopic transsphenoidal approach in the surgical treatment of pituitary adenomas. Methods We retrospectively analyzed the surgical effectiveness and complications of transsphenoidal approach under endoscope in treating 39 patients suffering from pituitary adenomas, including 37 with functional adenomas and 2 with non-functional adenomas. Results In all the patients with functional adenomas,tumors were totally resected. The 2 patients with non-functional adenoma invaded the seller obtained partial resection, and thus, postoperative radiotherapy was performed and preoperative symptoms were improved. All patients had no serious complications. All cases were followed up for 6-36 months: 1 had temporally visual loss; 11 appeared transient polyuria or diabetes insipidus; 2 developed cerebrospinal rhinorrhea, and they were cured after the treatment; headache was disappeared or relieved in 11, and sexual function got improvement in 7; the high preoperative PRL level was decreased to normal value in 37 patients after the surgery. Conclusion Endoscopic transsphenoidal technique, a safe, minimally invasive and efficient procedure for removing pituitary adenomas, offers simple and rapid access to the sella turcica and also provide direct visualization, thus improving the surgeon's ability to resect the tumors. Key words: Pituitary adenoma; Transsphenoidal approach; Nasalendoscope