Retrospective Analysis On Pituitary Tumor Resection By Endoscopic Transsphenoidal Approach

Objective: Endoscopic transnasal transsphenoidal approach has become the preferred procedureof pituitary tumor surgery, so the paper aims to discuss and summarize the diagnosis of pituitarytumors, as well as the indications, techniques, efficacy, complications and treatment of endoscopictransnasal transsphenoidal surgery by means of a retrospective analysis on the clinical data of37patients, so as to guide future clinical work.Methods: The clinical data, follow-up tracking and follow-up data of37patients who wereadmitted in Otolaryngology Department of our hospital from April2007to March2014andunderwent endoscopic transnasal transsphenoidal surgery were summarized and analyzed.Results: Among37cases,10cases of prolactinomas (27%),4cases of growth hormone adenoma(10.8%),7cases of adrenocorticotropic hormone adenoma (18.9%),1case of thyroid stimulatinghormone adenoma (2.8%) and4cases of multi-secreting adenoma (10.8%). there were33cases oftotal tumor resection,3cases of subtotal tumor resection and1case that failed to continue thetumor resection. Postoperative complications: there were16times of complications together,including5cases of transient diabetes insipidus,4cases of low cortisol,2cases of lowhyperthyroidism,1case of cerebrospinal fluid leakage,1case of acute myocardial infarction,1case of epilepsy,1case of deep vein thrombosis and1case of postoperative epistaxis. Curativeeffect: the surgical cure rate was73%(27/37), the improvement rate was18.9%(7/37), and theinvalid rate was8.1%(3/37).Conclusions: Endoscopic transsphenoidal pituitary tumor resection surgery is shorter in time withclearer vision and accurate positioning, which can avoid the blind angle in microscopic field withhigh full resection rate, accurate efficacy and no serious complications. The technology isapplicable not only to microadenoma, large adenoma, but also to encroaching cavernous sinus andthe giant adenomas or invasive pituitary tumors encasing the internal carotid artery, both of whichcan get satisfactory results. The surgeon is required to be skilled with endoscopic surgicaltechniques for this technology. Furthermore, the nasal mucosal flap with vascular pedicle playsthe advantages of exact reconstruction effect, faster healing, fewer complications, low cost in skullbase, which is worthy of clinical application. With the further improvement of endoscopictechniques and the application of intraoperative imaging navigation system, endoscopic transnasaltranssphenoidal pituitary tumor resection is bound to be widely promoted and applied.