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Updated: Aug 31, 2026
Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
[The clinical evaluation of patients with pituitary adenomas undergone transsphenoidal microsurgery]
Yao Zhao1, Shi-qi Li, Liang-fu Zhou
1Institution of Neurosurgery, Hua Shan Hospital, Fudan University, Shanghai, 200040, China.
Objective:
To evaluate the overall effect of transsphenoidal microsurgery for pituitary adenomas in recent 5 years and to discuss the surgical technique, application of new technology and postoperative follow-up results.
Methods:
The clinical presentation, image characteristics, endocrinal findings, pathological types, tumor removal percentage, postoperative complication and follow-up of 1 462 patients with pituitary adenomas who underwent the transsphenoidal microsurgery from 1997 to 2002 were analysed retrospectively.
Results:
Total rate of tumor removal for the patients achieved 97.0% in the patients with Hardy I adenomas, 95.2% with Hardy II, 90.5% with Hardy III, and 47.4% with Hardy IV respectively. A significant postoperative improvement both in clinical symptoms and endocrinal parameters was achieved. The tumor recurrence rate was 0.3%.
Conclusions:
With the improvement of microsurgical technique and application of novel technology, the indication of transsphenoidal microsurgery for pituitary adenomas was increasingly extended. Endoscope and(/or) neuronavigation-assisted microsurgery via transsphenoidal approach should be of the first choice for the treatment of pituitary adenomas. The routine postoperative radiotherapy is not required for patients with total tumor removal.
Insights
Transsphenoidal microsurgery effectively treats pituitary adenomas, achieving high tumor removal rates and improved patient outcomes. Advanced techniques like endoscopy and neuronavigation are recommended, with radiotherapy often unnecessary after complete tumor resection.
Area of Science:
- Neurosurgery
- Endocrinology
- Oncology
Context:
- Pituitary adenomas are common tumors affecting the endocrine system.
- Transsphenoidal microsurgery is a primary treatment modality.
- Evaluating recent advancements and outcomes is crucial for optimizing patient care.
Purpose:
- To assess the efficacy of transsphenoidal microsurgery for pituitary adenomas over a 5-year period.
- To analyze surgical techniques, new technologies, and follow-up results.
- To establish best practices for pituitary adenoma treatment.
Summary:
- Retrospective analysis of 1,462 patients undergoing transsphenoidal microsurgery from 1997-2002.
- High tumor removal rates achieved: Hardy I (97.0%), Hardy II (95.2%), Hardy III (90.5%), Hardy IV (47.4%).
- Significant improvements in clinical symptoms and endocrinal parameters observed, with a low recurrence rate (0.3%).
Impact:
- Improved surgical techniques and technology have expanded the indications for transsphenoidal microsurgery.
- Endoscope and/or neuronavigation-assisted microsurgery is recommended as the preferred approach.
- Routine postoperative radiotherapy is not necessary for patients with complete tumor removal, reducing patient burden and potential side effects.
