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KMID : 1001920130540040317
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Journal of Korean Neurosurgical Society
2013 Volume.54 No. 4 p.317 ~ p.322
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Feasibility of Endoscopic Endonasal Approach for Recurrent Pituitary Adenomas after Microscopic Trans-Sphenoidal Approach
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Hwang Joo-Min
Kim Yong-Hwy
Kim Jin-Wook
Kim Dong-Gyu
Jung Hee-Won
Chung Young-Seob
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Abstract
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Objective: The surgical approach for recurrent pituitary adenoma after trans-sphenoidal approach (TSA) is challenging. We report the outcomes of the endoscopic TSA for recurrent pituitary adenoma after microscopic TSA.
Methods: From February 2010 to February 2013, endoscopic TSA was performed for removal of 30 recurrent pituitary adenomas after microscopic TSA. Twenty-seven (90%) patients had a clinically non-functioning pituitary adenoma. Twenty-four (80%) patients suffered from a visual disturbance related to tumor growth. The clinical features and surgical outcomes were retrospectively analyzed for the ophthalmological, endocrinological, and oncological aspects.
Results: The mean tumor volume was 11.7 cm3, and gross total resection was achieved in 50% of patients. The volumetric analysis based on the postoperative MR showed that the mean extent of resection rates were 90%. Vision was improved in 19 (79%) of 24 patients with visual symptoms, and endocrinological cure was achieved in all of three functioning pituitary adenomas; however, the post-operative follow-up endocrinological examination revealed a new endocrinological deficit in one patient. Two patients required antibiotics management for post-operative meningitis.
Conclusion: The endoscopic TSA can be an effective treatment option for recurrent pituitary adenoma after microscopic TSA with acceptable outcome.
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KEYWORD
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Endoscopy, Revision surgery, Pituitary adenoma
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