title: [Repair and reconstruction of diaphragmatic defect during transcranial pituitary adenoma surgery].
abstract: OBJECTIVE
  To investigate the application value of titanium-clip and artificial menigeal in the sella diaphragm repair and reconstruction during transcranial pituitary adenoma surgery.
  
  
  METHODS
  Thirty eight patients undergoing transcranial pituitary adenoma surgery received sella diaphragmatic defect repair and reconstruction after the removal of tumor, intraoperative diaphragmatic defect was classified as three grades, titanium-clip, artificial menigeal and EC glue were used for the sella diaphragmatic repair and reconstruction. The short-term and long-term complications were compared with those in the control group which contains 74 patients without diaphragmatic reconstruction.
  
  
  RESULTS
  As 14 to 46 months' follow-up in the diaphragmatic reconstruction group, there were no leakage of cerebrospinal fluid(CSF), infections, empty sella syndrome (ESS), optic nerve damage, and any other severe complications was found. Only one inter-sella hemorrhage without optic nerve damage was found 3 hours after surgery by CT scan. In the group without diaphragmatic reconstruction, more secondary empty sella, cerebrospinal fluid rhinorrhea and intra-cranial infection were found after the following transsphenoidal surgery (P < 0.05), there was one case underwent the 2nd time transcranial surgery 1 hours later due to severe inter-sella hemorrhage resulting in vision damage and conscious disturbance. There was no significant difference in pituitary function and vision improvement between the two groups as the occurrence of diabetes insipidus (P > 0.05).
  
  
  CONCLUSIONS
  It is important to repair the sellae diaphragm defect during transcranial pituitary adenoma surgery, which could reduce short-term and long-term complication.
authors.affiliation: Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Pei-Zhi
authors.initials: PZ
authors.lastname: Zhou
authors.forename: Shu-Wen
authors.initials: SW
authors.lastname: Cheng
authors.forename: Zhang-Chao
authors.initials: ZC
authors.lastname: Yang
authors.forename: Wei-Chao
authors.initials: WC
authors.lastname: Ma
authors.forename: Wei
authors.initials: W
authors.lastname: Dong
authors.forename: Li-Lei
authors.initials: LL
authors.lastname: Peng
authors.forename: Shu
authors.initials: S
authors.lastname: Jiang
mesh_terms: D000236:Adenoma / Q000601:surgery*; D000328:Adult; D000368:Aged; D001860:Bone Plates; D004652:Empty Sella Syndrome / Q000150:complications / Q000601:surgery; D005260:Female; D006801:Humans; D007016:Hypophysectomy / Q000379:methods; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods; D010911:Pituitary Neoplasms / Q000601:surgery*; D019919:Prosthesis Implantation / Q000295:instrumentation / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012658:Sella Turcica / Q000473:pathology / Q000601:surgery*; D055815:Young Adult