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Endoscopic transsphenoidal surgery for resection of pituitary macroadenoma: A retrospective study
BACKGROUND: The endoscopic transsphenoidal approach is an efficient minimally invasive procedure for removal of pituitary tumors that can be accomplished through a one-hand or two-hand approach. The one-hand procedure through one nostril is more intuitive for surgeons, but maneuvering the instrument...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8345891/ https://www.ncbi.nlm.nih.gov/pubmed/34358251 http://dx.doi.org/10.1371/journal.pone.0255599 |
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author | Yan, Jiun-Lin Chang, Chen-Nen Chen, Pin-Yuan |
author_facet | Yan, Jiun-Lin Chang, Chen-Nen Chen, Pin-Yuan |
author_sort | Yan, Jiun-Lin |
collection | PubMed |
description | BACKGROUND: The endoscopic transsphenoidal approach is an efficient minimally invasive procedure for removal of pituitary tumors that can be accomplished through a one-hand or two-hand approach. The one-hand procedure through one nostril is more intuitive for surgeons, but maneuvering the instruments can be restrictive. The two-hand procedure using a one-and-half nostril approach provides more precise manipulation. This study aimed to compare the surgical outcomes of one-hand/mono-nostril and two-hand/one-and-half nostril surgeries for resection of large pituitary tumors by a single neurosurgeon. MATERIALS AND METHODS: The surgical data of 78 consecutive cases with pituitary macroadenoma (diameter >1 cm) were reviewed retrospectively. Altogether, 30 cases received one-hand/mono-nostril surgery, while 48 cases received two-hand/one-and-half nostril surgery. Postoperative outcomes of the two operations were compared. RESULTS: The operative time, hospital stay, residual rate of pituitary macroadenoma, visual field, surgical complications, and re-operative rates were slightly improved in the two-hand/one-and-half nostril surgery group compared with that in the one-hand/mono-nostril surgery group (all p>0.05). However, postoperative hypopituitarism was less frequent (1/48; 2.0%) with the two-hand/one-and-half nostril approach than with the mono-nostril approach (p = 0.004). Similar surgical outcomes were found in all patients with either small or large pituitary tumors, except that the difference in postoperative improvement in visual field change reached statistical significance (p = 0.044). CONCLUSION: A single-surgeon endoscopic endonasal transsphenoidal surgery with two-hand/one-and-half nostril approach is an effective and safe procedure for removal of large pituitary tumors. |
format | Online Article Text |
id | pubmed-8345891 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-83458912021-08-07 Endoscopic transsphenoidal surgery for resection of pituitary macroadenoma: A retrospective study Yan, Jiun-Lin Chang, Chen-Nen Chen, Pin-Yuan PLoS One Research Article BACKGROUND: The endoscopic transsphenoidal approach is an efficient minimally invasive procedure for removal of pituitary tumors that can be accomplished through a one-hand or two-hand approach. The one-hand procedure through one nostril is more intuitive for surgeons, but maneuvering the instruments can be restrictive. The two-hand procedure using a one-and-half nostril approach provides more precise manipulation. This study aimed to compare the surgical outcomes of one-hand/mono-nostril and two-hand/one-and-half nostril surgeries for resection of large pituitary tumors by a single neurosurgeon. MATERIALS AND METHODS: The surgical data of 78 consecutive cases with pituitary macroadenoma (diameter >1 cm) were reviewed retrospectively. Altogether, 30 cases received one-hand/mono-nostril surgery, while 48 cases received two-hand/one-and-half nostril surgery. Postoperative outcomes of the two operations were compared. RESULTS: The operative time, hospital stay, residual rate of pituitary macroadenoma, visual field, surgical complications, and re-operative rates were slightly improved in the two-hand/one-and-half nostril surgery group compared with that in the one-hand/mono-nostril surgery group (all p>0.05). However, postoperative hypopituitarism was less frequent (1/48; 2.0%) with the two-hand/one-and-half nostril approach than with the mono-nostril approach (p = 0.004). Similar surgical outcomes were found in all patients with either small or large pituitary tumors, except that the difference in postoperative improvement in visual field change reached statistical significance (p = 0.044). CONCLUSION: A single-surgeon endoscopic endonasal transsphenoidal surgery with two-hand/one-and-half nostril approach is an effective and safe procedure for removal of large pituitary tumors. Public Library of Science 2021-08-06 /pmc/articles/PMC8345891/ /pubmed/34358251 http://dx.doi.org/10.1371/journal.pone.0255599 Text en © 2021 Yan et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Yan, Jiun-Lin Chang, Chen-Nen Chen, Pin-Yuan Endoscopic transsphenoidal surgery for resection of pituitary macroadenoma: A retrospective study |
title | Endoscopic transsphenoidal surgery for resection of pituitary macroadenoma: A retrospective study |
title_full | Endoscopic transsphenoidal surgery for resection of pituitary macroadenoma: A retrospective study |
title_fullStr | Endoscopic transsphenoidal surgery for resection of pituitary macroadenoma: A retrospective study |
title_full_unstemmed | Endoscopic transsphenoidal surgery for resection of pituitary macroadenoma: A retrospective study |
title_short | Endoscopic transsphenoidal surgery for resection of pituitary macroadenoma: A retrospective study |
title_sort | endoscopic transsphenoidal surgery for resection of pituitary macroadenoma: a retrospective study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8345891/ https://www.ncbi.nlm.nih.gov/pubmed/34358251 http://dx.doi.org/10.1371/journal.pone.0255599 |
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