title: The Surgical Side Effects of Pseudocapsular Resection in Nonfunctioning Pituitary Adenomas.
abstract: OBJECTIVE
  Pseudocapsular resection is a useful surgical technique for removing functioning pituitary adenomas; however, the significance of this procedure in nonfunctioning pituitary adenomas (NFPAs) had not been discussed in detail. We clarify the safety of pseudocapsular resection in NFPAs based on the incidence of surgical complications and evaluation of pituitary function.
  
  
  METHODS
  In 143 patients, initial surgery for NFPAs was performed with preoperative and postoperative pituitary provocation tests. Patients were categorized into 3 groups: total group (n = 65), in which the pseudocapsule was totally removed; partial group (n = 11), in which the pseudocapsule was partially removed; and nonremoval group (n = 67), in which the pseudocapsule was not removed or did not exist. The main outcome measure was the incidence of surgical complications and postoperative pituitary functions.
  
  
  RESULTS
  Intraoperative cerebrospinal fluid leakage and temporary diabetes insipidus occurred more frequently in the total group than in the nonremoval group; however, the differences were not statistically significant. There was no difference in the incidence of any other complications, including postoperative cerebrospinal fluid leakage and permanent diabetes insipidus, between the total and nonremoval groups. Postoperative anterior pituitary function improved to the same degree in both the total and the nonremoval groups. Univariate and multivariate analyses revealed that pseudocapsular resection was not a factor in the postoperative deterioration of pituitary function.
  
  
  CONCLUSIONS
  Pseudocapsular resection in NFPAs does not increase the risk of surgical complications or aggravate postoperative pituitary function.
authors.affiliation: Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan. Electronic address: y-kinoshita@hiroshima-u.ac.jp.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Kinoshita
authors.affiliation: Department of Neurosurgery, Hiroshima Prefectural Hospital, Hiroshima, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Tominaga
authors.affiliation: Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Usui
authors.affiliation: Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Arita
authors.affiliation: Department of Neurosurgery, Hiroshima Prefectural Hospital, Hiroshima, Japan.
authors.forename: Tetsuhiko
authors.initials: T
authors.lastname: Sakoguchi
authors.affiliation: Department of Clinical Oncology and Neuro-oncology Program, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Sugiyama
authors.affiliation: Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Kaoru
authors.initials: K
authors.lastname: Kurisu
mesh_terms: D000236:Adenoma / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D065634:Cerebrospinal Fluid Leak / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D010911:Pituitary Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Extracapsular dissection; Nonfunctioning pituitary adenoma; Pseudocapsular resection; Transsphenoidal surgery