Neuronavigation-Guided Pure Endoscopic Endonasal Transsphenoidal Surgery for Complex Pituitary Adenomas
- VernacularTitle:导航辅助内镜下经鼻蝶手术治疗复杂垂体腺瘤
- Author:
Yajun XUE
1
;
Yaodong ZHAO
;
Daming CUI
;
Zhaoli SHEN
;
Meiqing LOU
Author Information
1. 上海交通大学附属上海第一人民医院神经外科
- Keywords:
Giant pituitary adenoma;
Invasive pituitary adenoma;
Recurrent pituitary adenoma;
Neuroendoscopy;
Pure endoscopic endonasal transsphenoidal surgery;
Neuronavigation
- From:
Chinese Journal of Clinical Medicine
2015;(1):95-98
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the efficacy of neuronavigation‐guided pure endoscopic endonasal transsphenoidal approach for the surgical removal of complex pituitary adenomas .Methods :The clinical data of 60 patients who received pure endoscopic endonasal transsphenoidal surgery for complex pituitary adenomas from Apr 2010 to Sep 2012 was retrospectively analyzed . These patients had one or more characteristics which including tumors more than 4 cm in size(34 patients) ,Knosp grade 3‐4(41 patients) ,recurrent or residual tumor(17 patients) .All patients received pure endoscopic endonasal transsphenoidal surgery and neuronavigation was used . Neuro‐ophthalmological , neuroimaging and endocrinological examination were performed postoperatively .Results:There were 33 nonfunctional adenomas and 27 functional adenomas .Overall ,the tumors were gross totally removed in 42 patients ,subtotal removed in 11 patients and partially removed in 7 patients .Postoperative visual acuity was improved in 32 patients ,endocrine remission was achieved in 8 patients .The gross total removal was achieved in 18 ,23 and 12 patients for tumors more than 4 cm in size ,Knosp grade 3‐4 adenomas ,recurrent or residual adenomas ,respectively .The postoperative complications included electrolyte disturbances in 4 patients ,cerebral spinal fluid leakage in 3 patients ,insipidus in 1 patient .And 1 patient had visual impairment ,hypopituitarism and hypersomnia caused by postoperative hemorrhage .And 5 patients had reoperation .Conclusions :Neuronavigation‐guided pure endoscopic endonasal transsphenoidal surgery is safe and effective for complex pituitary adenoma .The effectiveness of that approach for invasive pituitary adenomas (Knosp grade 4) and complex functional adenomas still need to be promoted .
