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Extended transsphenoidal approach for the removal of invasive pituitary adenoma(117 cases analysis)

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Author:
No author available
Journal Title:
CHINESE JOURNAL OF NEUROSURGERY
Issue:
1
DOI:
10.3760/cma.j.issn.1001-2346.2009.01.005
Key Word:
垂体腺瘤;侵袭性;扩大经蝶窦入路;Pituitary adenoma;Invasion;Extended transsphenoidal approach

Abstract: Objective To study the value of extended transsphenoidal approach to invasive pituitary adenoma.Method Between September 1999 and March 2007,117 patients with invasive pituitary adenoma underwent surgery via extended transsphenoidal approach.The clinical data and follow-up of this series were retrospectively analyzed.Resuits 14 adenomas extended anteriorly to anterior cranial base,103 laterally to cavernous sinus,27 posteriorly to elivus.Total tumor removal was achieved in 73 cases,subtotal removal in 40,and partial removal in 4.Transient postoperative complications included 7 cases of CSF fistulae,5 cases of partial cranial nerve palsy,and 5 cases of acute panhypopituitarism.Permanent neurological complications included 2 cases of carotid artery injury,2 cases of monocular blindness and one case of diabetes insipidus.There was no perioperative mortality.The follow-up period ranged from 3 months to 8 years.The tumor recurrence was observed in two patients and then was treated with gamma knife.There was no reoperation.Conclusion The extended transsphenoidal approach could provide excellent exposure of tumors.The rate of total tumor removal is high,while the complication is few.This procedure has been proved to be an effective and perfect way to remove invasive pituitary adenomas.Operation,radiotherapy and medicine treatment are comprehensive treatment for invasive pituitary adenomas.

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