Analysis Of Surgical Indications For Recurrent Pituitary Adenomas

Objective: to explore the indications of reoperation for recurrent pituitary adenomas by collecting the clinical data of patients treated with different surgical methods.Methods: The postoperative complications,clinical cure rate,tumor resection rate,tumor invasion and tumor size of 43 patients with recurrent pituitary adenomas were retrospectively analyzed from Jan.2012 to Dec.2015 in Ningxia Medical University General Hospital,and then the significantly different factors would be performed with X2 test.Results: 21 patients underwent resection of tumor by transsphenoidal approach of microscope:the incidence of postoperative complications was 23.81%(n = 5/21),the total resection rate of tumor was 76.19%(n= 16/21),the clinical cure rate was 95.23%(n = 20/21),the large adenoma accounted for 100%(n = 21/21),and the invasive tumor accounted for66.66%(n = 14/21);6 patients underwent resection of tumor by transsphenoidal approach of endoscopic:the incidence of postoperative complications was 33.33%(n = 2/6),and the total tumor resection rate was 66.66%(n = 4/6),the clinical cure rate was 83.33%(n= 5/6),the large adenoma accounted for 100%(n = 6/6),and the invasive tumor accounted for 100.00%(n = 6/6);8 patients underwent craniotomy adenocarcinoma resection:the incidence of postoperative complications was 25.00%(n = 2/8),and the total tumor resection rate was62.50%(n =5/8),the clinical cure rate was 75.00%(n= 6/8),the large adenoma accounted for100%(n = 8/8),and the invasive tumor accounted for 75.00%(n = 6/8).Conclusion: the surgical indications of this study are:TSS(including endoscopy,microscope)indication:Most of the tumors were located in the pituitary fossa and in the suprasellar region;Thetop of the tumor had no contact with the internal cerebral vein or blocked the interventricular foramen;And the bottom of the tumor reached the sellar floor or into the sphenoid sinus;the huge adenoma according to the planned division of TSS resection.Craniotomy indications:There were more scar tissues in the pituitary fossa;Most of the tumors were located on the saddle,and it was estimated that the tumors were difficult to be satisfiedly settled during operation;symptoms obviously need surgery,and the butterfly surgery is difficult to achieve satisfactory results.