title: [Anterior interhemispheric approach for giant sellar region tumors in a series of 110 consecutive patients].
abstract: OBJECTIVE
  To explore the techniques and efficacies of surgical resection of giant sellar region tumors via anterior interhemispheric approach.
  
  
  METHODS
  A series of 110 consecutive cases of giant sellar region tumors undergoing microsurgery through an anterior interhemispheric approach at our hospital were retrospectively analyzed. Their mean age was 35.6 (3-72) years. There were craniopharyngioma (n = 57), pituitary adenoma (n = 33), hypothalamic glioma (n = 5), meningioma (n = 4) and other lesions (n = 11). The maximal tumor diameter varied from 4.0 to 8.2 cm with a mean diameter of 4.8 cm. Active measurements were taken for managing blood sodium disorder and diabetes insipidus. During the follow-ups, the patients were monitored for residual or recurrent tumor by hormonal assessment (in cases of functioning adenomas) and postoperative contrast magnetic resonance imaging (MRI) performed 1-3 months after surgery.
  
  
  RESULTS
  Total lesion removal was achieved in 76 cases (69.1%). Twenty patients (18.2%) underwent subtotal resection and 14 (12.7%) had partial removal. No surgery-related mortality occurred. Visual acuity was preserved or improved in 97 patients (88.2%) within 1 week after surgery. The major postoperative complications included diabetes insipidus (n = 76, 69.1%), permanent diabetes insipidus (n = 23, 20.9%), electrolyte disorder (n = 62, 56.4%), seizures (n = 7, 6.4%), brain damage (3 cerebral contusions and 5 hematomas) (n = 8, 7.3%) and infarction(n = 2, 1.8%). During a median post-surgical follow-up period of 26 (3-96) months, 11 patients had recurrence. And 35 cases (31.8%) of endocrinological deficit received hormonal replacement after surgery.
  
  
  CONCLUSIONS
  The interhemispheric approach is feasible for removing giant sellar region tumors without significant sequels. Active postoperative managements of diabetes insipidus and electrolyte disorder may accelerate early patient recovery.
authors.affiliation: Department of Neurosurgery, PLA General Hospital, Beijing 100853, China.
authors.forename: Yanyang
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, PLA General Hospital, Beijing 100853, China. Email: shjwkk@sina.com.
authors.forename: Bainan
authors.initials: B
authors.lastname: Xu
authors.affiliation: Department of Neurosurgery, PLA General Hospital, Beijing 100853, China.
authors.forename: Jinli
authors.initials: J
authors.lastname: Jiang
authors.affiliation: Department of Neurosurgery, PLA General Hospital, Beijing 100853, China.
authors.forename: Shiyu
authors.initials: S
authors.lastname: Feng
authors.affiliation: Department of Neurosurgery, PLA General Hospital, Beijing 100853, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Bu
authors.affiliation: Department of Neurosurgery, PLA General Hospital, Beijing 100853, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Zhou
authors.affiliation: Department of Neurosurgery, PLA General Hospital, Beijing 100853, China.
authors.forename: Xinguang
authors.initials: X
authors.lastname: Yu
authors.affiliation: Department of Neurosurgery, PLA General Hospital, Beijing 100853, China.
authors.forename: Dingbiao
authors.initials: D
authors.lastname: Zhou
mesh_terms: D000236:Adenoma; D000293:Adolescent; D000328:Adult; D000368:Aged; D001932:Brain Neoplasms; D002648:Child; D002675:Child, Preschool; D003397:Craniopharyngioma; D006801:Humans; D007031:Hypothalamus; D008279:Magnetic Resonance Imaging; D008577:Meningeal Neoplasms; D008579:Meningioma; D008866:Microsurgery; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010911:Pituitary Neoplasms; D011183:Postoperative Complications; D011184:Postoperative Period; D012189:Retrospective Studies; D019292:Skull Base Neoplasms; D055815:Young Adult