[Endoscopic intrasellar tumor surgery].

OBJECTIVE

To report the experience with the perioperative management of endoscopic intrasellar tumor surgery in fifty-two patients with intrasellar tumor who underwent an endoscopic transsphenoidal approach to the sella.

METHODS

The application of transnasal endoscopic technique to the management of pituitary adenomas in 49 patients, of craniopharyngioma in two patients and of meningeoma in one patient.

RESULTS

Forty-eight of forty-nine cases with pituitary adenomas and two cases with craniopharyngioma were removed completely, the majority of one case with invasive pituitary adenoma and the meningeoma were removed on purpose to decompress. The symptoms of headache, visual desturbance, amenorrhea, galactorrhea ect. were cured or improved. The endocrinological evaluation: the high preoperative prolactin (PRL) and growth hormone (GH) level were decreased to normal values after the operation. Transient and permanent diabetes insipidus occurred in five patients and one patient with pituitary adenomas respectively after the operation, only one case required the treatment. One patient with craniopharyngioma had postoperative epilypsy. Two patients with pituitary adenomas and one patient with craniopharyngioma had recurrence within the one-year (recurrence rate 5.8%) during the follow-up 3-72 months after the surgery. No patient developed a delayed cerebrospinal fluid leak, meningitis, optic nerves injury, internal carotid injury, or other endocrine complications.

CONCLUSION

This new technique offers simple and rapid access to the sella turcica and also, direct visualization, improves the surgeons ability to resect tumors, it is a safe, minimally invasive and efficient procedure for removing intrasellar tumor.