The Microsurgical Treatment Of The Giant Pituitary Adenomas

Objectives: By analyzing the clinical cases, to discuss the curative effect and surgery skills of giant pituitary adenoma (diameter≥3cm) by microsurgery, and to summarize the experience of the surgery.Methods: A retrospective study of giant pituitary adenoma was carried out in 88 patients after surgery from December, 2006 to the December, 2008. 38 male cases and 50 female cases, aged 18～65 years old, average 39.5 years old. All patients underwent CT and MRI scan, eyesight and visual filed inspection and hormone level determination. By 4 kind of different operative approaches, compared with the total excision rate, the surgery effect and the complication.Results: In the 88 cases, pituitary adenoma of 81 cases were totally resected, 7 were subtotally resected. The total excision rate was 92.05%, and there was not serious complication or death case postoperation. The eyesight improved obviously in 72 cases, not changed in 14 cases and worsened in 2 case. At follow-up, the pituitary hormone level recovered in 36 cases, and decreased in 10 cases. 50 persons can take care of oneself completely, 4 cannot and 1 dead (because of other diseases). 1 case underwent operation 2 years later because of recurrence.Conclusions: The appropriate operative approach and the surgery strategy, knowledge of anatomy and microsurgical experience were the key factors of surgical treatment of giant pituitary adenoma , that can enhance the total excision rate, reduce the complication.