Results of Resection of Giant Pituitary Adenomas through Endoscopic Endonasal Approach

Zubair Mustafa Khan, Hannan Tayyab, Syed Ahmad Faizan, Sumaira Kiran, Aqeel Butt, Asif Bahsir
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Abstract

Background/Objective:  A minimally invasive surgical method is in use to create endoscopic transsphenoidal surgery. Because of the intricate dissection of the sellar region, surgical treatment of large pituitary adenomas is challenging. The study focused to determine the frequency of complications after endonasal endoscopic transsphenoidal resection of giant pituitary macroadenomas. Materials and Methods:  A descriptive case series study was conducted at the Neurosurgical Department of Lahore General Hospital, Lahore. A total of 70 patients fulfilling the selection criteria were enrolled. Major vascular injury was noted when there is an injury to the internal carotid artery or cavernous sinus. After discharge, patients were followed-up in OPD for 3 months. After 3 months, patients were evaluated for CSF leak and vision. The presence of complications was recorded. During surgery, operative time was noted. Results:  Mean age of patients was 55.7 ± 6.5 years. 45.71% of patients were male while the remaining 54.29% of patients were female Total of 41.43% of patients had disease < 2 years, whereas the duration of surgery was ? 3 hours in 64.3% of patients. A total 15.71% had complications which included diabetes insipidus (8.57%), infections (5.71%), pituitary dysfunction (4.29%), CSF leak (2.8%) and vascular injury (1.43%). The mortality rate was 1.43%. Conclusion:  The complication rate after endonasal endoscopic transsphenoidal resection of giant pituitary macroadenomas was high. Keywords:  Endonasal Endoscopic, Transsphenoidal Resection, Pituitary Macroadenomas, Complications
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经鼻内窥镜入路切除巨大垂体腺瘤的结果
背景/目的:采用一种微创手术方法进行内镜下经蝶窦手术。由于鞍区解剖复杂,大垂体腺瘤的手术治疗具有挑战性。本研究的重点是确定经鼻内窥镜下经蝶窦切除巨大垂体大腺瘤后并发症的发生率。材料和方法:在拉合尔总医院神经外科进行了描述性病例系列研究。共有70名符合选择标准的患者入组。当内颈动脉或海绵窦受到损伤时,可注意到主要的血管损伤。出院后在门诊随访3个月。3个月后,评估患者脑脊液泄漏和视力。记录并发症的发生情况。术中记录手术时间。结果:患者平均年龄55.7±6.5岁。45.71%的患者为男性,其余54.29%的患者为女性。41.43%的患者病程< 2年,而手术时间为?64.3%的患者为3小时。并发症15.71%,其中尿崩症(8.57%)、感染(5.71%)、垂体功能障碍(4.29%)、脑脊液漏(2.8%)、血管损伤(1.43%)。死亡率为1.43%。结论:鼻内窥镜下经蝶窦切除垂体巨腺瘤术后并发症发生率高。关键词:鼻内窥镜,经蝶窦切除术,垂体大腺瘤,并发症
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