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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
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Transsphenoidal Approach for Pituitary Adenomas in Elderly Patients
Stephanie H Chen1, Annelise Sprau1, Leon Chieng1
1Miller School of Medicine, University of Miami, Miami, Florida, USA.
World Neurosurgery
|October 8, 2018
Summary
Transsphenoidal endoscopic endonasal resection is a safe and effective treatment for pituitary adenomas in elderly patients over 70. This procedure demonstrates similar surgical and endocrinologic outcomes compared to younger patients, with comparable permanent complication rates.
Area of Science:
- Neurosurgery
- Endocrinology
- Geriatric Medicine
Background:
- The incidence of pituitary adenomas is increasing in the aging US population.
- Evaluating surgical options for elderly patients with pituitary adenomas is crucial.
Purpose of the Study:
- To assess the safety and efficacy of transsphenoidal endoscopic endonasal resection for pituitary adenomas in patients over 70 years old.
- To compare surgical outcomes between elderly (>70 years) and non-elderly (<70 years) patients.
Main Methods:
- Retrospective review of 131 patients undergoing transsphenoidal endoscopic endonasal resection for pituitary adenomas.
- Analysis of preoperative, intraoperative, and surgical outcomes, comparing elderly and non-elderly cohorts.
Main Results:
- Elderly patients presented with more vision loss and larger tumors.
- Surgical and endocrinologic outcomes were similar between age groups.
- Non-elderly patients had higher rates of gross total resection and transient complications, but permanent complication rates were comparable.
Conclusions:
- Transsphenoidal endoscopic endonasal resection is a safe and effective approach for pituitary adenomas in selected elderly patients.
- Appropriate patient selection is key for successful outcomes in older adults.
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