Treatment of pituitary adenomas by neuroendoscopic surgery combined with drill via endonasal transsphenoidal approach

Abstract

Objective To evaluate the surgical technique and experience of endoscopic endonasal transsphenoidal approach combined with drill in surgical treatment of pituitary adenomas.Methods We retrospectively analyzed the clinical data of 29 patients suffered from pituitary adenomas,collected from September 2007 to August 2011 in our hospital,and the surgical technique and experience of endoscopic endonasal transsphenoidal approach in treating them. Results Total resection was achieved in 19 patients (65.5％),subtotal resection in 8 (27.6％) and partial resection in 2 (6.9％).Cerebrospinal leak appeared in 4 patients and temporary diatetes insipidus in 27 patients, and all these complications were controlled after treatment. Follow-up was performed for 3-8 months; the acuity of vision was improved in 15 patients (83.33％); the defect of visual field was improved in 8 (80％); headache was disappeared or relieved in 9 (81.82％).The high preoperative prolactin (PRL) level in 15 patients was obviously decreased from ([304.55+181.30] μg/L) to ([43.27+28.75] μg/L) 3 months after the surgery (P＜0.05); the high preoperative growth hormone (GH) level in 6 patients was obviously decreased from ([48.16+22.36] ng/L) to ([14.03+4.57] ng/L) 3 months afterthesurgery (P＜0.05).Conclusion Neuroendoscopic surgery combined with drill via endonasal transsphenoidal approach in the treatment of pituitary adenomas is a safe,minimally invasive and efficient procedure. Key words: Nenroendoscopy; Trausnasal-sphenoidal approach; Pituitary adenoma; Drill