Endoscopic transsphenoidal treatment of pituitary adenomas.
OBJECTIVE
To explore the techniques and methods of endoscopic transnasal transsphenoid surgery for pituitary adenoma.


METHODS
We treated 678 cases with pituitary adenoma by endoscopic transsphenoidal surgery between May 2000 and May 2006. All cases were operated through a transnasal transsphenoid approach between the nasal septum and middle nasal concha, first to enlarged sphenoid ostium and opened sellar floor with a high-speed drill and then removed the tumor step by step. Sixty-two percent of cases (420 cases) got 6-24 months of follow-up.


RESULTS
Among the 678 pituitary adenomas, tumor removal was total in 543 (80.1%), subtotal in 118 (17.4%) and partial in 17 (2.5%). Ninety-eight percent (643 of 655 cases) obtained an improvement in clinical symptoms at some extent after the operation. Post-operative complication (including subarachnoid hemorrhage, nasal cavity bleed, nostril infection, nasal wing deformation and cerebrospinal fluid nasal leakage) occurred in 21 patients (3%). Among the 420 follow-up patients, tumor in four cases recurred 2 years after the first operation.


CONCLUSIONS
Endoscopic transsphenoidal surgery of pituitary adenomas is a valuable microinvasive neurosurgery technique of minimal invasiveness, being effective and safe, yet requiring simple manipulation. With technological and scientific advancements, endoscopic transsphenoidal surgery will improve and develop step by step.
Zhang
Yazhuo
Y
Division of Neurosurgery, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing 10050, China. zyz2004520@163.com
Wang
Zhongcheng
Z
Liu
Yejian
Y
Zong
Xuyi
X
Song
Ming
M
Pei
Ao
A
Zhao
Peng
P
Zhang
Pengfei
P
Piao
Mingxue
M
D000236:Adenoma / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007016:Hypophysectomy / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D044583:Neuroendoscopy / Q000379:methods*; D010911:Pituitary Neoplasms / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D013101:Sphenoid Sinus / Q000601:surgery*