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Surgical Endoscopy

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Open Access 01-06-2015 | Review

Endoscopic endonasal transsphenoidal surgery of 1,166 pituitary adenomas

Authors: Fuyu Wang, Tao Zhou, Shaobo Wei, Xianghui Meng, Jiashu Zhang, Yuanzheng Hou, Guochen Sun

Published in: Surgical Endoscopy | Issue 6/2015

Abstract

Aim

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.

Materials and 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.

Result

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 %).

Conclusion

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.

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Title: Endoscopic endonasal transsphenoidal surgery of 1,166 pituitary adenomas
Authors: Fuyu Wang
Tao Zhou
Shaobo Wei
Xianghui Meng
Jiashu Zhang
Yuanzheng Hou
Guochen Sun
Publication date: 01-06-2015
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 6/2015
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-014-3815-0

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Endoscopic endonasal transsphenoidal surgery of 1,166 pituitary adenomas

Abstract

Aim

Materials and methods

Result

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Aim

Materials and methods

Result

Conclusion

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