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KMID : 1037420070020010023
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Journal of Korean Skull Base Society
2007 Volume.2 No. 1 p.23 ~ p.27
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Clinical Experience of Large Pituitary Adenomas Treated by Transsphenoidal Approach
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Yang Seung-Ho
Kim Il-Sup
Hong Jae-Taek
Sung Jae-Hoon
Son Byung-Chul
Lee Sang-Won
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Abstract
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Objective: The purpose of this study is to determine the feasibility of transsphenoidal approach (TSA) and staged or repeated TSA for large pituitary adenoma (LPA) and remnant or recurrent PA.
Methods: Eighteen LPAs underwent TSA surgery from February 2002 to December 2006. Eleven cases were non-functioning adenomas, 5 cases were growth hormone secreting adenomas and 2 cases were pituitary apoplexy. Mean size of tumor was 38x28x30mm. All patients were initially operated via TSA.
Results: Total removal was performed in 8 patients (44.4%). Subtotal removal was done in 8 patients (44.4%) by the initial TSA, two patients in which underwent repeated TSA due to postoperative tumor bleeding. The visual and hormonal symptoms were improved in 13 patients (72.2%) after the surgery. Six patients out of 8 with subtotal removal underwent the staged operation. Two patients with tumor recurrence underwent repeated TSA, 18 and 26 months respectively after the initial TSA. All patients with growth hormone-secreting PA achieved the normalization of growth
hormone.
Conclusion: The staged and repeated TSA is one of the feasible option for the treatment of LPA and residual or recurrent PA with acceptable surgical morbidity and mortality.
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KEYWORD
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Pituitary adenomas, Operation, Transshenoidal approach, Recurrence Complication
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