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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
Endoscopic endonasal transsphenoidal surgery for functional pituitary adenomas
Christoph P Hofstetter1, Benjamin J Shin, Lynn Mubita
1Department of Neurological Surgery, Weill Cornell Medical College, New York–Presbyterian Hospital, New York, New York 10021, USA.
Neurosurgical Focus
|April 5, 2011
Summary
Endoscopic pituitary adenoma surgery shows high remission rates, especially for tumors with suprasellar extension. Extent of resection and suprasellar involvement are key predictors of successful endocrinological cure.
Area of Science:
- Neurosurgery
- Endocrinology
- Oncology
Background:
- Pituitary adenomas are common tumors affecting hormone regulation.
- Therapy-resistant adenomas require effective surgical intervention.
- Endoscopic endonasal resection offers a minimally invasive approach.
Purpose of the Study:
- To identify preoperative predictors of endocrinological remission after endoscopic resection of functional pituitary adenomas.
- To establish benchmarks for cure using current consensus criteria.
- To analyze outcomes for prolactin-, GH-, and ACTH-secreting tumors.
Main Methods:
- Prospective review of 86 functional pituitary adenomas treated with endoscopic endonasal transsphenoidal surgery.
- Postoperative MRI assessed the extent of tumor resection.
- Endocrinological remission defined by the latest consensus criteria.
Main Results:
- Gross-total resection achieved in 75.6% of patients.
- Cure rates varied by tumor type and size, with higher rates for microadenomas.
- Multivariate analysis identified extent of resection and suprasellar extension as significant predictors of cure.
- Complications included meningitis, panhypopituitarism, and CSF leaks.
Conclusions:
- Endoscopic pituitary surgery provides benchmarks for endocrinological cure.
- Tumors with suprasellar extension and cavernous sinus invasion benefit most from extended endonasal approaches.
- Extent of resection is a critical factor for achieving remission.
