title: Endonasal endoscopic pituitary adenoma resection: preservation of neurohypophyseal function.
abstract: OBJECTIVE
  In the past 10 years, endoscopic resection of pituitary adenomas has become an alternative to microsurgical resection with the additional advantage of increasing the patient's postoperative comfort. This analysis explored whether endoscopic resection can reduce the risk of postoperative neurohypophyseal dysfunction.
  
  
  METHODS
  We rated and compared the need to administer desmopressin during the first four postoperative days and with the need after a follow-up of at least 3 months (chronic administration).
  
  
  METHODS
  Three groups of patients were compared: Patients in group 1 were operated on microscopically. Patients in group 2 were operated on endoscopically. Patients in group 3 were operated on endoscopically with intraoperative magnetic resonance imaging (iMRI).
  
  
  METHODS
  Group 1 was made up of 50 patients treated in 1999; group 2 comprised 50 patients operated on from 2006 to 2007; and Group 3 comprised 50 patients operated on in 2008.
  
  
  METHODS
  In group 1 the need to use desmopressin postoperatively occurred in eight patients; three needed chronic treatment. In group 2 the need for postoperative application of desmopressin occurred in four patients; none required chronic treatment. In group 3 desmopressin had to be administered postoperatively in five patients but only temporarily.
  
  
  CONCLUSIONS
  Endoscopic surgery is a safe and effective method for the resection of pituitary adenomas. The rate of chronic desmopressin application was reduced. In conjunction with iMRI and navigation, the endoscopic technique allows increased radicality together with fewer adverse effects.
authors.affiliation: Department of Neurosurgery, 1st Faculty of Medicine, Charles University and Central Military Hospital, Prague, Czech Republic.
authors.forename: Vaclav
authors.initials: V
authors.lastname: Masopust
authors.affiliation: Department of Neurosurgery, 1st Faculty of Medicine, Charles University and Central Military Hospital, Prague, Czech Republic.
authors.forename: David
authors.initials: D
authors.lastname: Netuka
authors.affiliation: Department of Neurosurgery, 1st Faculty of Medicine, Charles University and Central Military Hospital, Prague, Czech Republic.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Benes
authors.affiliation: Department of Neurosurgery, 1st Faculty of Medicine, Charles University and Central Military Hospital, Prague, Czech Republic.
authors.forename: Ondrej
authors.initials: O
authors.lastname: Bradac
authors.affiliation: 3rd Department of Medicine, 1st Faculty of Medicine, Charles University, Prague, Czech Republic.
authors.forename: Josef
authors.initials: J
authors.lastname: Marek
authors.affiliation: 3rd Department of Medicine, 1st Faculty of Medicine, Charles University, Prague, Czech Republic.
authors.forename: Vaclav
authors.initials: V
authors.lastname: Hana
mesh_terms: D000236:Adenoma / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods*; D009666:Nose; D010904:Pituitary Gland, Posterior / Q000502:physiology / Q000601:surgery*; D010911:Pituitary Neoplasms / Q000601:surgery*; D016896:Treatment Outcome