Clinical Efficacy Analysis Of29Cases Of Pituitary Microadenomas With Microsurgery Treatment

Objective To analyse the clinical effect of microsurgical treatment forpituitary microadenomas.Methods A retrospective analysis was performed from January2009toMarch2014, which included29cases of pituitary microadenomas（16PRLadenomas,7ACTH adenomas,4GH adenomas,1mixed adenoma, and1non-functioning adenomas） treated by transsphenoidal surgery from thedepartment of neurosurgery, the First Affiliated Hospital of Guangxi MedicalUniversity. A comparison of endocrine hormone levels, clinical features, andMRI results of preoperative and postoperative pituitary microadenomas wasconducted for judging the efficacy of microsurgery therapy.Results The postoperative hormone levels of all the29pituitarymicroadenoma patients were statistically significant lower than the preoperativelevels(P＜0.05). Among the29pituitary microadenomas,21cases were totalresection and8cases were subtotal resection displayed on MRI. After thesurgery, diabetes insipidus performance of the one non-functioning adenomasreturn to normal. Headache and dizziness performance of the16PRL and1mixed adenoma disappeared. All the7cases adenoma（6PRL and1mixed） stoped lactation. One out of the2PRL adenoma infertility patients recoverpregnant，and sexual function of the one out of the3PRL adenoma sexualdysfunction patients improved. All the2PRL adenoma secondary amenorrheapatients restore menstruation，and8out of the13PRL adenoma menstrualdisorder patients restore menstrual regularity. Visual disturbance of4PRL and1ACTH adenoma all improved. Dizziness performance and Cushing’s syndromemanifestations of the5/7ACTH adenomas patients improved obviously. TightSkin feeling and acromegaly face of all the4GH adenomas patients improved.The total improvement rate of all the adenomas patients treated bytranssphenoidal surgery was82.8%（24/29），with81.2%（13/16）in PRLadenoma,100%(4/4)in GH adenoma, and71.4%(5/7) in ACTH adenoma.Conclusion It is curative to resect the adenoma by transsphenoidalmicrosurgery through unilateral nostril, the postoperative hormone levelsdropped and the clinical manifestation and MRI performance improvedobviously after the surgery，and the effect of the transsphenoidal microsurgeryfor PRL and GH adenoma was more obvious than ACTH adenoma.