Transsphenoidal Microsurgery Of Pituitary Adenoma Analyzing The Influential Factorsof The Postoperative Complications

Transsphenoidal surgery for pituitary adenoma resection with small trauma, operation effect is good, safe time saving, complications and death rate low characteristic, has been more and more neurosurgeons adopted. Is the road for surgery combined, also has the advantage of minimally invasive, for the overwhelming majority of neurosurgery doctor recommended. In view of the pituitary tumor involving the anatomy of the complex relationship between adjacent to saddle area, pituitary tumor is easy to cause complications. Such as urinary collapse disease, hyponatremia, pituitary function low and so on question is still the most common place. The transsphenoidal microsurgical treatment pituitary adenoma, postoperative cannot avoid completely these complications. The following discussion and these complications related factors.Objectives:Discussion related factors (gender, age, duration, tumor size, break through the saddle septum, intraoperative texture, resection degree and operation time, postoperative immunohistochemical disease inspection results) and transsphenoidal surgery postoperative complications (urine collapse, hyponatremia, pituitary function is low) of the relationship. Summarize transsphenoidal surgery adenomas were treatment clinical experience. Improve the operation level and the operation effect, reduce postoperative complications of may and puts forward the corresponding prevention measures, and provide a reference for clinical.Material and method:Collect shanxi medical university first affiliated hospital2007-8-2011-3to120patients between the transsphenoidal surgery patients for clinical data do retrospective study. We will gender, age, duration, tumor size, break through the saddle septum, intraoperative texture, resection degree and operation time, postoperative immunohistochemical disease inspection results9index as influencing factors, and the disc postoperative complications urine collapse, hyponatremia, pituitary function is low establish logistic many factor analysis model, line logistic regression analysis. Analysis by the butterfly effect pituitary adenoma postoperative common complications of related factors.Results:120patients with pituitary adenoma transsphenoidal surgery patients. Male51cases, female69cases. Aged17to75years old, an average of45.98years. Course2days-10years, an average of2.75years. Adenoma biggest diameter0.8cm,5.9cm, averages2.8cm. Tumor imaging breakthrough to saddle the saddle instead of91cases. Tumor quality of a material soft group92examples, quality of a material of toughness28cases. All95patients with tumor resection, most resection25cases. Operation time45-330minutes before, an average of112minutes. Hormones and pathologic diagnosis:PRL adenoma29), GH adenoma in7cases, ACTH adenoma, TSH adenoma, FSH adenoma, LH adenoma each in1, and no functional adenoma in49cases, much hormone adenoma (31cases).The postoperatie urine collapse disorder in71cases, mostly for the collapse of urine. Postoperative hyponatremia29patients. Postoperative pituitary function is low, there were64cases, but low cortisol23cases, low thyroid element48cases.Complications occurred more factor regression showed that:resection degree (beta=1.091, P=0.046, OR=2.976) is the influence factors of postoperative urine collapse. The biggest diameter of pituitary adenoma (beta=0.503, P=0.035, OR=1.654) is postoperative hyponatremia factors. The biggest diameter of pituitary adenoma (beta=0.433, P=0.048, OR=1.543) is the low pituitary function of influencing factors. Groups in the group analysis shows that no functional adenoma in49cases, low pituitary function after surgery in34patients. And71cases of function of the pituitary function after surgery appears low30cases, the chi-square test with significant difference (P=0.005). No functional adenomas and adenoma biggest diameter of simple linear regression (P=0.019) with significant difference. This group of no functional adenoma is the biggest diameter of the function. Conclusion:The transsphenoidal surgery patients with urinary collapse, pituitary tumor resection related degree. Surgical resection and postoperative urine collapse degree were positively correlated. The biggest diameter of the tumor, the bigger the butterfly in the pituitary adenoma resection of the more concurrent hyponatremia.The biggest diameter of the tumor and the pituitary function is low were positively correlated. Analysis of the pituitary gland tumors product, the bigger the normal surrounding the pituitary gland organization of the greater the oppression, the more likely to cause postoperative pituitary function is low. Another factor analysis results show that the statistics and pituitary adenoma PRL negative correlation function is low. Analysis PRL adenomas to endocrine change, earlier onset, surgical methods on the surrounding tissue damage is still not quite, pituitary function more reserves.No functional adenoma is functional pituitary adenomas are more likely to low pituitary function after surgery. No functional adenoma of function and the diameter of the biggest diameter of the remarkable difference. May be due to no functional adenoma normally no symptoms, found a volume has increased to, already on the surrounding the pituitary gland organization oppression to pituitary function is low.