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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
19.1K
Surgery is a safe, effective first-line treatment modality for noninvasive prolactinomas
Ji Yong Park1, Wonsuk Choi1, A Ram Hong1
1Division of Endocrinology and Metabolism, Department of Internal Medicine, Chonnam National University Medical School, 264 Seoyang-ro, Hwasun-eup, Hwasun-gun, Jeollanam-do, 58128, Korea.
Pituitary
|June 30, 2021
Summary
Transsphenoidal surgery offers comparable outcomes to dopamine agonists for non-invasive prolactinomas. Surgery showed better DA-free remission, but treatment choice depends on individual patient factors.
Area of Science:
- Endocrinology
- Neurosurgery
- Oncology
Background:
- Dopamine agonists (DAs) are standard first-line treatment for prolactinomas.
- Advances in surgical techniques are increasing the use of surgery for prolactinomas.
Purpose of the Study:
- Compare treatment outcomes of dopamine agonists (DAs) versus transsphenoidal surgery for non-invasive prolactinomas.
- Evaluate efficacy and remission rates for both treatment modalities.
Main Methods:
- Retrospective review of 70 patients with prolactinomas (Knosp grade 0-1) from 2004-2020.
- Compared 29 patients who underwent surgery with 41 patients initially treated with DAs.
Main Results:
- Surgery group achieved superior dopamine agonist-free remission and structural response.
- Tumor size was larger in the surgery group, yet outcomes were better.
- Symptom control and biochemical response were comparable between groups.
Conclusions:
- Transsphenoidal surgery is a viable option for non-invasive prolactinomas with low complication rates.
- Surgery demonstrated better long-term remission potential.
- Individualized treatment decisions are crucial for optimal prolactinoma management.
