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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...

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Autores principales: Yan, Jiun-Lin, Chang, Chen-Nen, Chen, Pin-Yuan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
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.
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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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