title: [Minimally invasive neurosurgery for removal of pituitary adenomas by neuroendoscope aided with sellar floor reconstruction].
abstract: OBJECTIVE
  To evaluate the effect of surgical technique and clinical curative effect for a unilateral endonasal-transsphenoidal approach in the removal of pituitary adenomas (PAs) by an endoscope-assisted technique with sellar floor reconstruction.
  
  
  METHODS
  Between April 2001 and March 2009, 426 consecutive patients underwent extended neuroendoscopic unilateral endonasal transsphenoidal surgery. The series consisted of 54 (12.7%) as I type of Pas and 105 (24.6%) II type, 181(42.5%) III type and 86 (20.2%) IV type according to Hardy's classification criteria of pituitary adenoma.
  
  
  RESULTS
  Tumor removal, as assessed by intraoperative findings and postoperative magnetic resonance imaging or CT scans, revealed complete tumor removal in 370 cases (86.9%) and subtotal tumor removal in 32 cases (7.5%) were achieved. Partial removal was carried out in the remaining 24 cases (5.6%) with fibrous tumor. Three patients (0.7%) had postoperative death in this group. Twenty-four patients (5.6%) had a postoperative cerebrospinal fluid leak that required repair operations. Six patients (1.4%) experienced a sphenoid mucositis and meningitis and they were cured by medical therapy.
  
  
  CONCLUSIONS
  The slightly soft texture of PAs with or without a limited suprasellar extension and without involvement of vascular structures, may be resected through such an extended neuroendoscopic transsphenoidal approach. Intraoperative angled endoscope is a useful adjunct for safe removals.
authors.affiliation: Neurosurgical Institute of Chinese PLA, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China. xzhang@fmmu.edu.cn
authors.forename: Xiang
authors.initials: X
authors.lastname: Zhang
authors.forename: Zhou
authors.initials: Z
authors.lastname: Fei
authors.forename: Jian-ning
authors.initials: JN
authors.lastname: Zhang
authors.forename: Luo-an
authors.initials: LA
authors.lastname: Fu
authors.forename: Wei-dong
authors.initials: WD
authors.lastname: Cao
authors.forename: Yan
authors.initials: Y
authors.lastname: Qu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D044583:Neuroendoscopy; D010911:Pituitary Neoplasms / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012658:Sella Turcica / Q000601:surgery*; D055815:Young Adult