title: Endoscopic endonasal transsphenoidal surgery of 1,166 pituitary adenomas.
abstract: OBJECTIVE
  To report the results of a series of patients undergoing pure endoscopic endonasal pituitary surgery and to evaluate the efficacy and safety of this procedure.
  
  
  METHODS
  The data of 1,166 patients that underwent endoscopic endonasal transsphenoidal adenoma removal between December 2006 and June 2013 were retrospectively reviewed. Pre- and postoperative hormonal status (3 months after surgery) were analyzed and compared with the clinical parameters originally presented by the patients. The incidences of tumor removal, hormonal control, and tumor removal complications were retrospectively analyzed.
  
  
  RESULTS
  Out of 577 nonfunctioning adenomas, 180 were growth hormone (GH) secreting, 308 prolactin (PRL) secreting, 26 mixed GH/PRL adenomas, 68 adrenocorticotropin secreting, and 7 thyroid-stimulating hormone-secreting adenomas. The gross total removal of pituitary adenomas was achieved in 98 % of microadenomas, 92 % of macroadenomas, and 76 % of giant adenomas. Hormonal control was achieved in 47 (69 %) cases of ACTH adenomas, 119 (66 %) GH adenomas, 262 (85 %) PRL adenomas, and 6 (86 %) TSH adenomas. Postoperative complications were observed in 168 (14.4 %) patients. The most frequent complications were diabetes insipidus (7 %), epistaxis (1.7 %), hyposmia (1.5 %), anterior lobe insufficiency (1.3 %) ,and CSF leaks (0.6 %).
  
  
  CONCLUSIONS
  The pure endoscopic approach is a safe, efficacious, and minimally invasive technique for the removal of pituitary adenomas. A higher gross total resection rate is vital for non-functional and functional adenomas. For patients with functional adenomas, while hormonal remission is unlikely to be achieved by surgery, the use of adjuvant therapy is advocated to obtain long-term hormonal control.
authors.affiliation: Department of Neurosurgery, PLA 301 Hospital, Beijing, 100853, China.
authors.forename: Fuyu
authors.initials: F
authors.lastname: Wang
authors.forename: Tao
authors.initials: T
authors.lastname: Zhou
authors.forename: Shaobo
authors.initials: S
authors.lastname: Wei
authors.forename: Xianghui
authors.initials: X
authors.lastname: Meng
authors.forename: Jiashu
authors.initials: J
authors.lastname: Zhang
authors.forename: Yuanzheng
authors.initials: Y
authors.lastname: Hou
authors.forename: Guochen
authors.initials: G
authors.lastname: Sun
mesh_terms: D000236:Adenoma / Q000601:surgery*; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods*; D009666:Nose; D010911:Pituitary Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D013101:Sphenoid Sinus / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome