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Pablo Ajler, Santiago Hem, Ezequiel Goldschmidt, Federico Landriel, Alvaro Campero, Claudio Yampolsky, Antonio Carrizo
Surgical Neurology International 2012 3(7):389-394
Background: To explain the technique used and to describe the outcome of the first 52 patients who underwent endoscopic transnasal surgery to treat pituitary tumors at our institution. Methods: We carried out a retrospective analysis of 52 patients in whom endoscopic transnasal surgery for pituitary tumors was performed during the period from June 2011 to June 2012. We analyzed the demographic characteristics of these patients, their underlying disease, and the morbidity and mortality associated with surgery. Results: The mean age was 41.52 years, ranging from 18 to 79. The distribution was similar between men and women. The most common types of adenoma were: Non-functioning adenomas (40.4%), GH-producing tumors/Acromegaly (25%) and ACTH-producing tumors/Cushing's disease (23.1%). Approximately 70% were macroadenomas. Only one patient had complications. There was no death in this series. Conclusion: Although more definitive conclusions will be drawn after further study of this technique, our impression is that the endoscopic view seem to provide more anatomical details than microscopic one. Moreover, it allows direct visualization of remaining tumor, sites of cerebrospinal fluid leakage and the normal gland, since the endoscope may be introduced into the sella. These advantages may allow achieving better surgical outcomes in terms of disease control and complication prevention.
Surgical Neurology International 2012 3(7):389-394
Background: To explain the technique used and to describe the outcome of the first 52 patients who underwent endoscopic transnasal surgery to treat pituitary tumors at our institution. Methods: We carried out a retrospective analysis of 52 patients in whom endoscopic transnasal surgery for pituitary tumors was performed during the period from June 2011 to June 2012. We analyzed the demographic characteristics of these patients, their underlying disease, and the morbidity and mortality associated with surgery. Results: The mean age was 41.52 years, ranging from 18 to 79. The distribution was similar between men and women. The most common types of adenoma were: Non-functioning adenomas (40.4%), GH-producing tumors/Acromegaly (25%) and ACTH-producing tumors/Cushing's disease (23.1%). Approximately 70% were macroadenomas. Only one patient had complications. There was no death in this series. Conclusion: Although more definitive conclusions will be drawn after further study of this technique, our impression is that the endoscopic view seem to provide more anatomical details than microscopic one. Moreover, it allows direct visualization of remaining tumor, sites of cerebrospinal fluid leakage and the normal gland, since the endoscope may be introduced into the sella. These advantages may allow achieving better surgical outcomes in terms of disease control and complication prevention.
