Abstract:
Objective To analyze the complications and preventive measures after endoscopic transnasal sphenoidal surgery for pituitary adenoma.
Method A retrospective analysis was conducted on 41 cases of endoscopic transsphenoidal surgery for pituitary adenoma from July 2008 to September 2011. Imaging data (CT and MRI) and endocrinological examination before and after surgery were summarized. A follow-up was performed on 33 (80.5%) cases after 6 to 24 months.
Results Of the 41 cases of endoscopic transsphenoidal surgery for pituitary adenoma, 32 were total tumor resection cases (78.0%), 7 were subtotal resection cases (17.1%), and 12 were partial resection cases (4.9%). Blood endocrine status after the operation also improved. Ten patients exhibited post-operative complications as follows: 1 case of hyposmia, 1 case of SAH, 1 case of sphenoid sinus cyst, 3 cases of cerebrospinal fluid rhinorrhea, 3 cases of permanent diabetes insipidus, and 1 case of transient heat and electrolyte disturbance. Of the 33 follow-up patients, 2 cases relapsed in 2 years after the first operation.
Conclusion Endoscopic transnasal sphenoidal surgery for pituitary adenoma has minimal invasiveness and clear exposure of operation field. The patients achieve satisfactory therapeutic effect if nasal packing is pre-operatively done, endoscopy is performed, the processing tumors and tumor cavity are meticulously and intraoperatively done, and the complications are actively treated after operation.
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