<strong>Background:</strong> Advances in the era of modern micro-neurosurgery enabled a reduction of surgical invasiveness and brain retraction which has been defined as minimally invasive or keyhole surge...<strong>Background:</strong> Advances in the era of modern micro-neurosurgery enabled a reduction of surgical invasiveness and brain retraction which has been defined as minimally invasive or keyhole surgery. Sinonasal endoscopy has brought radical changes in the concepts of pathophysiology and treatment of sinonasal aliments as well as surgical techniques. <strong>Aim of the Study:</strong> To compare between the use of endoscopic and microscopic trans-sphenoidal approach in resection of growth hormone-secreting pituitary adenomas with Suprasellar Extension. <strong>Patients and Methods:</strong> This is a prospective study. It had been conducted upon 20 patients having growth hormone secreting pituitary adenoma admitted to Neurosurgery department in Alzar University hospitals and Nasr City Insurance hospital from 2015 to 2018, divided into 2 groups;group A (10 cases) underwent endoscopic endonasal trans-sphenoidal pituitary adenoma resection, while group B (10 cases) operated upon using the standard microscopic trans-sphenoidal pituitary adenoma resection. The inclusion criteria were included: All patients with growth hormone secreting pituitary adenomas showing manifestations of acromegaly, mass effect or hormonal disturbance. <strong>Results:</strong> This study showed that improvement in outcome was higher in endoscopic group opposed to microscopic group (100% vs. 71% improved headache, 80% vs. 60% visual improvement, 75% vs. 20% fundus improvement and 60% vs. 30% field improvement).<strong> Conclusion:</strong> We concluded that fully endoscopic procedure result in improved rates of complete tumor removal and a reduced incidence of complications, when compared to the microscopic approach.展开更多
Objective:This study mainly discusses the clinical effect of treating pituitary adenoma by using single nostril transsphenoidal resection of pituitary adenoma under neuro-endoscope,and analyzes the influence on hospit...Objective:This study mainly discusses the clinical effect of treating pituitary adenoma by using single nostril transsphenoidal resection of pituitary adenoma under neuro-endoscope,and analyzes the influence on hospitalization time and bleeding volume.Methods:A total of 335 patients with pituitary adenoma treated in our hospital from January 2017 to January 2019 were randomly selected for study.The patients were divided into two groups by number table method.167 patients in the reference group underwent single nostril transsphenoidal resection of pituitary adenoma under microscope.Also,168 patients in the study group underwent single nostril transsphenoidal resection of pituitary adenoma under neuroendoscope.The hospitalization time and bleeding volume and other surgical treatment effects were observed and compared.Results:There was no significant difference in the levels of prolactin(PRL),adrenocorticotropic hormone(ACTH)and thyroid stimulating hormone(TSH)between the two groups before operation(P>0.05);After surgical treatment,the levels of PRL,ACTH and TSH in the study group were lower than those in the control group(P<0.05);In terms of surgical indexes,the operation time and hospital stay in the study group were shorter than those in the reference group,and the amount of surgical bleeding was less than that in the reference group(P<0.05);The total tumor resection rate in the study group was higher than that in the reference group,and the incidence of complications such as nasal septal defect,cerebrospinal fluid leakage and diabetes insipidus in the study group was lower than that in the reference group(P<0.05).Conclusion:For pituitary adenoma diseases,using single nostril transsphenoidal resection of pituitary adenoma under neuroendoscope can improve the tumor resection rate,reduce the bleeding volume and shorten postoperative hospitalization time.展开更多
文摘<strong>Background:</strong> Advances in the era of modern micro-neurosurgery enabled a reduction of surgical invasiveness and brain retraction which has been defined as minimally invasive or keyhole surgery. Sinonasal endoscopy has brought radical changes in the concepts of pathophysiology and treatment of sinonasal aliments as well as surgical techniques. <strong>Aim of the Study:</strong> To compare between the use of endoscopic and microscopic trans-sphenoidal approach in resection of growth hormone-secreting pituitary adenomas with Suprasellar Extension. <strong>Patients and Methods:</strong> This is a prospective study. It had been conducted upon 20 patients having growth hormone secreting pituitary adenoma admitted to Neurosurgery department in Alzar University hospitals and Nasr City Insurance hospital from 2015 to 2018, divided into 2 groups;group A (10 cases) underwent endoscopic endonasal trans-sphenoidal pituitary adenoma resection, while group B (10 cases) operated upon using the standard microscopic trans-sphenoidal pituitary adenoma resection. The inclusion criteria were included: All patients with growth hormone secreting pituitary adenomas showing manifestations of acromegaly, mass effect or hormonal disturbance. <strong>Results:</strong> This study showed that improvement in outcome was higher in endoscopic group opposed to microscopic group (100% vs. 71% improved headache, 80% vs. 60% visual improvement, 75% vs. 20% fundus improvement and 60% vs. 30% field improvement).<strong> Conclusion:</strong> We concluded that fully endoscopic procedure result in improved rates of complete tumor removal and a reduced incidence of complications, when compared to the microscopic approach.
文摘Objective:This study mainly discusses the clinical effect of treating pituitary adenoma by using single nostril transsphenoidal resection of pituitary adenoma under neuro-endoscope,and analyzes the influence on hospitalization time and bleeding volume.Methods:A total of 335 patients with pituitary adenoma treated in our hospital from January 2017 to January 2019 were randomly selected for study.The patients were divided into two groups by number table method.167 patients in the reference group underwent single nostril transsphenoidal resection of pituitary adenoma under microscope.Also,168 patients in the study group underwent single nostril transsphenoidal resection of pituitary adenoma under neuroendoscope.The hospitalization time and bleeding volume and other surgical treatment effects were observed and compared.Results:There was no significant difference in the levels of prolactin(PRL),adrenocorticotropic hormone(ACTH)and thyroid stimulating hormone(TSH)between the two groups before operation(P>0.05);After surgical treatment,the levels of PRL,ACTH and TSH in the study group were lower than those in the control group(P<0.05);In terms of surgical indexes,the operation time and hospital stay in the study group were shorter than those in the reference group,and the amount of surgical bleeding was less than that in the reference group(P<0.05);The total tumor resection rate in the study group was higher than that in the reference group,and the incidence of complications such as nasal septal defect,cerebrospinal fluid leakage and diabetes insipidus in the study group was lower than that in the reference group(P<0.05).Conclusion:For pituitary adenoma diseases,using single nostril transsphenoidal resection of pituitary adenoma under neuroendoscope can improve the tumor resection rate,reduce the bleeding volume and shorten postoperative hospitalization time.
