Objective To discuss the surgical procedures and its advantages and disadvantages.Methods Theunilateral trans-septal endonasal approach was employed. Zero degree neuroendoscope was used for nasal mucosal dissection an...Objective To discuss the surgical procedures and its advantages and disadvantages.Methods Theunilateral trans-septal endonasal approach was employed. Zero degree neuroendoscope was used for nasal mucosal dissection and exploration of anterior wall of sphenoid sinus. The sphenoidotomy was done with the anatomic landmark of inferior margin of middle turbinate and ostia . After the identification of internal carotid artery and optic nerve, the pituitary fossa was opened. Then cut the dura , the margin between adenoma and normal tissue was very clear under endoscope. tumor can be removed safely. There were two patients with suprasellar extension, 30-degree endoscope was used and excellent visualization and tumor removal were obtained. Results No severe complication occurred. Conclusion Endoscopic assisted transsphenoidal pituitary surgery is practical because the operation is done under excellent illumination and visualization.展开更多
Objective To study the advantage of modified methods involving incision,repairation of the sella floor etc.in transsphenoidal approach for pituitury tumor removal.Methods The transsphenoidal approach with one endonasa...Objective To study the advantage of modified methods involving incision,repairation of the sella floor etc.in transsphenoidal approach for pituitury tumor removal.Methods The transsphenoidal approach with one endonasal incision of mucosa was performed for resecting pituitary tumor in 86 patients,of which total resection of the tumor in 67 cases and subtotal in 19 cases.Results There was no case with postoperative meningitis and rhinoseptal perforation.Tachocombs were used for repairation of the tumor resection cavection cavity and the sella floor,of which there was no case with postoperative CSF leakage happened.Conclusion These modified methods simplified operative procedurej Areduced damage and prevented postoperative complications of CSF leakage and rhinoseptal perforation etc.展开更多
Background The presence of residual tumor after surgery for pituitary adenoma may necessitate further treatment. The suprasellar and parasellar extension of the tumor have been widely considered as the predictors for ...Background The presence of residual tumor after surgery for pituitary adenoma may necessitate further treatment. The suprasellar and parasellar extension of the tumor have been widely considered as the predictors for residual tumor. However there is scarcity of studies regarding the preoperative tumor volume and residual tumor. This study was conducted to evaluate if tumor volume could predict the outcome of transsphenoidal pituitary surgery. Methods A prospective study was designed and 48 patients who underwent transsphenoidal pituitary surgery within 1 year in the First Affiliated Hospital of Xi＇an Jiaotong University were included in this study. The preoperative tumor volume and immediate postoperative tumor volume （within 4-7 days） were calculated in the contrast magnetic resonance imaging by using the formula of ellipsoid. All these volumes were divided into three subgroups, i.e. group 1, group 2 and group 3 with preoperative volume of less than 4 cm3, 4-8 cm3, and more than 8 cm3 respectively. The parasellar and suprasellar extension of the tumor were also classified by Knosp and modified Hardy＇s classifications. Results Baseline characteristics were comparable. The preoperative tumor volume of more than 8 cm3 （group 3, （12.1±1.1） cm3） had increased risk on postoperative tumor residue （P 〈0.01） than the other two groups （（2.1±0.3） cm3 and （6.1±0.3） cm3 in groups 1 and 2）. The mean postoperative volume in group 3 patients （（2.2±0.1） cm3） was significantly higher than the other two groups （P 〈0.01）. Conclusion Preoperative volume of more than 8 cm3 can be considered as a predictor for postoperative residual volume.展开更多
文摘Objective To discuss the surgical procedures and its advantages and disadvantages.Methods Theunilateral trans-septal endonasal approach was employed. Zero degree neuroendoscope was used for nasal mucosal dissection and exploration of anterior wall of sphenoid sinus. The sphenoidotomy was done with the anatomic landmark of inferior margin of middle turbinate and ostia . After the identification of internal carotid artery and optic nerve, the pituitary fossa was opened. Then cut the dura , the margin between adenoma and normal tissue was very clear under endoscope. tumor can be removed safely. There were two patients with suprasellar extension, 30-degree endoscope was used and excellent visualization and tumor removal were obtained. Results No severe complication occurred. Conclusion Endoscopic assisted transsphenoidal pituitary surgery is practical because the operation is done under excellent illumination and visualization.
文摘Objective To study the advantage of modified methods involving incision,repairation of the sella floor etc.in transsphenoidal approach for pituitury tumor removal.Methods The transsphenoidal approach with one endonasal incision of mucosa was performed for resecting pituitary tumor in 86 patients,of which total resection of the tumor in 67 cases and subtotal in 19 cases.Results There was no case with postoperative meningitis and rhinoseptal perforation.Tachocombs were used for repairation of the tumor resection cavection cavity and the sella floor,of which there was no case with postoperative CSF leakage happened.Conclusion These modified methods simplified operative procedurej Areduced damage and prevented postoperative complications of CSF leakage and rhinoseptal perforation etc.
文摘Background The presence of residual tumor after surgery for pituitary adenoma may necessitate further treatment. The suprasellar and parasellar extension of the tumor have been widely considered as the predictors for residual tumor. However there is scarcity of studies regarding the preoperative tumor volume and residual tumor. This study was conducted to evaluate if tumor volume could predict the outcome of transsphenoidal pituitary surgery. Methods A prospective study was designed and 48 patients who underwent transsphenoidal pituitary surgery within 1 year in the First Affiliated Hospital of Xi＇an Jiaotong University were included in this study. The preoperative tumor volume and immediate postoperative tumor volume （within 4-7 days） were calculated in the contrast magnetic resonance imaging by using the formula of ellipsoid. All these volumes were divided into three subgroups, i.e. group 1, group 2 and group 3 with preoperative volume of less than 4 cm3, 4-8 cm3, and more than 8 cm3 respectively. The parasellar and suprasellar extension of the tumor were also classified by Knosp and modified Hardy＇s classifications. Results Baseline characteristics were comparable. The preoperative tumor volume of more than 8 cm3 （group 3, （12.1±1.1） cm3） had increased risk on postoperative tumor residue （P 〈0.01） than the other two groups （（2.1±0.3） cm3 and （6.1±0.3） cm3 in groups 1 and 2）. The mean postoperative volume in group 3 patients （（2.2±0.1） cm3） was significantly higher than the other two groups （P 〈0.01）. Conclusion Preoperative volume of more than 8 cm3 can be considered as a predictor for postoperative residual volume.
