title: Three-Dimensional Endoscopic Endonasal Approach and Outcomes in Sellar Lesions: A Single-Center Experience of 104 Cases.
abstract: BACKGROUND
  Pituitary tumors account for approximately 15% of primary intracranial neoplasms and often are diagnosed incidentally. Common sellar lesions are pituitary adenomas, craniopharyngiomas, and Rathke cleft cysts. Currently endoscopic transsphenoidal approaches are largely used, and many centers also use 3-dimensional (3D) technology, although additional results of long-term follow-up are still being accumulated.
  
  
  METHODS
  We present a retrospective analysis of 104 patients with sellar lesions (57 male and 47 female, mean age 52 years) who underwent 3D endoscopic transsphenoidal surgery in our center from December 2011 to March 2015 and were followed up for a mean time of 18 months.
  
  
  RESULTS
  A total of 16 patients were diagnosed with growth hormone-secreting adenomas, 9 with adrenocorticotropic hormone-secreting, 5 with prolactin-secreting, and 2 with thyroid-stimulating hormone-secreting tumors and 58 with nonsecreting pituitary adenomas. Five patients had Rathke cleft cysts, 5 craniopharyngiomas, 2 fibrous solitary tumors, 1 a metastasis, and 1 a chordoma. At baseline, 47 patients (45.2%) had hormonal changes and 52 (50%) had visual field changes. Complete resection was achieved in 73 patients (70.1%). Follow-up evaluation detected hormonal remission in 7 patients with Cushing disease (77.7%) and in 11 patients with acromegaly (68.7%). Complications were cerebrospinal fluid leak in 5 cases (4.8%) and transient diabetes insipidus in 6 cases (5.7%). A total of 55 patients (52.9%) were discharged less than 72 hours after surgery.
  
  
  CONCLUSIONS
  The use of an endoscopic endonasal approach with 3D technology provides several advantages relating to patient length of stay, rate of complications, postoperative recovery, and novice surgeons' training. Advantages of 3D endoscopy and long-term follow-up still need further elucidation.
authors.affiliation: Division of Neurosurgery, Department of Neurosciences, A. O. U. Città della Salute e della Scienza di Torino, Turin, Italy. Electronic address: valentinapennacchietti@gmail.com.
authors.forename: Valentina
authors.initials: V
authors.lastname: Pennacchietti
authors.affiliation: Division of Ear, Nose and Throat 1, Department of Surgical Sciences, A. O. U. Città della Salute e della Scienza di Torino, Turin, Italy.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Garzaro
authors.affiliation: Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, A. O. U. Città della Salute e della Scienza di Torino, Turin, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Grottoli
authors.affiliation: Division of Neurosurgery, Department of Neurosciences, A. O. U. Città della Salute e della Scienza di Torino, Turin, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Pacca
authors.affiliation: Division of Neurosurgery, Department of Neurosciences, A. O. U. Città della Salute e della Scienza di Torino, Turin, Italy.
authors.forename: Diego
authors.initials: D
authors.lastname: Garbossa
authors.affiliation: Division of Neurosurgery, Department of Neurosciences, A. O. U. Città della Salute e della Scienza di Torino, Turin, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Ducati
authors.affiliation: Division of Neurosurgery, Department of Neurosciences, A. O. U. Città della Salute e della Scienza di Torino, Turin, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Zenga
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000000981:diagnostic imaging / Q000601:surgery; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D044583:Neuroendoscopy / Q000009:adverse effects / Q000379:methods*; D009666:Nose; D011183:Postoperative Complications; D012189:Retrospective Studies; D013100:Sphenoid Bone; D016896:Treatment Outcome; D055815:Young Adult
keywords: 3D endoscopy; Craniopharyngioma; Endoscopic endonasal surgery; Pituitary adenoma; Rathke cleft cyst; Transsphenoidal approach