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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
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Pseudocapsule and pseudocapsule-based extracapsular resection in pituitary neuroendocrine tumors
Xiao Bin Wang1, Tian Yi Han2, Jian Gong Ma1
1Department Of Neurosurgery, The First Affiliated Hospital of Henan University, Kaifeng, Henan, China.
Frontiers in Endocrinology
|December 5, 2022
Summary
Extracapsular resection (ER) using the pituitary tumor pseudocapsule offers better outcomes than intracapsular resection (IR). This endoscopic technique improves gross total resection and remission rates for pituitary neuroendocrine tumors (PitNETs) without increasing complications.
Area of Science:
- Neurosurgery
- Endocrinology
- Oncology
Background:
- The pseudocapsule is the anatomical interface between pituitary neuroendocrine tumors (PitNETs) and the normal pituitary gland.
- Extracapsular resection (ER) is a surgical technique that utilizes the pseudocapsule for tumor removal.
- Conventional intracapsular resection (IR) is an alternative surgical method for PitNETs.
Purpose of the Study:
- To review the literature over the past 10 years on the efficacy of ER compared to IR for PitNETs.
- To evaluate the impact of ER on gross total resection (GTR), biochemical remission, and tumor recurrence.
- To assess the safety profile of ER in terms of postoperative complications.
Main Methods:
- Literature review of studies published in the last 10 years.
- Analysis of surgical outcomes including GTR, biochemical remission, and recurrence rates.
- Comparison of complication rates between ER and IR techniques.
Main Results:
- Endoscopic transsphenoidal resection, particularly ER, is increasingly preferred for PitNETs.
- ER demonstrated higher rates of GTR and biochemical remission compared to IR.
- ER was associated with reduced tumor recurrence and no increase in postoperative complications.
Conclusions:
- The pseudocapsule is a valuable anatomical landmark for PitNET surgery.
- Extracapsular resection (ER) is a safe and effective surgical technique for PitNETs, offering superior outcomes to IR.
- Neurosurgeons should consider and promote the clinical application of ER for PitNETs.
