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157405

Surgical Outcome of Endoscopic Transsphenoidal Surgery for Giant Pituitary Adenoma

Article

Last updated: 24 Dec 2024

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Tags

Surgery

Abstract

Background: Pituitary adenomas are benign neoplasms representing 10 to 15% of intracranial lesions. Giant pituitary adenomas describe tumors more than 4 cm in maximum diameter and represent 6-10% of pituitary tumors. The introduction oftruly ‘extended endonasal' approaches has enabled thepituitary surgeon to achieve a more radical resection safely.
The aim of the work: Evaluation of efficacy of the endoscopic endonasal approach in managing giant pituitary adenoma.
Patients and methods: Fifteenpatients with giant pituitary adenomas were enrolled. They were submitted to full clinical examination, radiological, visual, and hormonal assessment in the pre and postoperative period. A purely endoscopic endonasal approach was used as the primary surgical management for all the patients. The collected data included preoperative data, tumor characteristics, resection rate, clinical outcome, recurrence rate, and need for adjuvant radiotherapy
Results: The mean age was 40.7 [range 16-57] years, with a male predominance [60%]. Visual affection was reported in [86.6%] with pituitary hormonal hypersecretion in 53.3%. There was an improvement in 80% of patients with visual field defects and 83.3% of patients with diminished visual acuity. Prolactin hormone levels normalized in 40%, while growth hormone normalized in 33.3%. Follow-up MRI revealed gross total resection [GTR] in 41.6% of patients with suprasellar extension, subtotal removal [about 80% of the tumor] in 50% of patients, partial tumor resection in one patient [8.4%].  In para-sellar extension, subtotal resection achieved [in 66.6%], and partial resection in 33.3%. Postoperative CSF leak occurred in 13.3% due to uncomplete reconstruction of the sella. They were reoperated for sella repair and augmentation. Three patients [20%] had transient [for 3 weeks] postoperative diabetes insipidus [DI] in the early postoperative period.
Conclusion: Endoscopic endonasal approach is an effective and safe approach for managing giant pituitary adenomas.

DOI

10.21608/ijma.2021.62003.1272

Keywords

pituitary, Giant, Transsphenoidal, endonasal, Endoscopic

Authors

First Name

Abdulrahman Alrefaey

Last Name

Aldengawy

MiddleName

Fouad

Affiliation

Department of Neurosurgery, Damietta Faculty of Medicine, Al-Azhar University, Egypt

Email

dr_aldengawy@yahoo.com

City

-

Orcid

-

First Name

Ahmed Mohamed

Last Name

Taha

MiddleName

-

Affiliation

Department of Neurosugery, Damietta Faculty of Medicine, Al-Azhar University, Egypt

Email

ahmed.tahaneuros@domazhermedicine.edu.eg

City

Gamalia, Dakahlia

Orcid

-

First Name

Mostafa Alsayed

Last Name

Mohamed

MiddleName

-

Affiliation

Department of Neurosurgery, Faculty of Medicine, Al-Azhar University, Egypt

Email

malgrem5@gmail.com

City

Cairo

Orcid

-

Volume

3

Article Issue

2

Related Issue

24821

Issue Date

2021-04-01

Receive Date

2021-02-20

Publish Date

2021-04-01

Page Start

1,288

Page End

1,298

Print ISSN

2636-4174

Online ISSN

2682-3780

Article File

IJMA_Volume 3_Issue 2_Pages 1288-1298.pdf

PDF . 1.4MB

Link

https://ijma.journals.ekb.eg/article_157405.html

Detail API

https://ijma.journals.ekb.eg/service?article_code=157405

Order

17

Type

Original Article

Type Code

816

Publication Type

Journal

Publication Title

International Journal of Medical Arts

Publication Link

https://ijma.journals.ekb.eg/

MainTitle

Surgical Outcome of Endoscopic Transsphenoidal Surgery for Giant Pituitary Adenoma

Details

Type

Article

Created At

22 Jan 2023