The Factors Related to the Tumor Resection Rate in Endoscopic Transsphenoidal Surgery for Pituitary Adenoma

Kamiya Koki, Yamamuro Shun, Ozawa Yoshinari, Shibuya Koji, Oshima Hideki, Yoshino Atsuo

doi:10.4264/numa.78.6_353

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下垂体腺腫に対する神経内視鏡下経蝶形骨洞手術の腫瘍摘出率を向上させる因子の検討
カスイタイセンシュニタイスルシンケイナイシキョウカケイチョウケイホネドウシュジュツノシュヨウテキシュツリツオコウジョウサセルインシノケントウ

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Endoscopic transsphenoidal surgery (eTSS) is widely employed for the surgical treatment of pituitary adenoma. Surgery-assisted endoscopy offers a wider visual field than previous methods and allows surgeons to readily approach the cavernous sinus, which is the most difficult area to resect. Extensive opening of the sellae floor is necessary when the tumor invades the cavernous sinus; however, the evidence supporting this remains inadequate. We retrospectively investigated 31 consecutive cases of pituitary adenoma that were treated via endoscopic transphenoidal surgery. These cases were divided into 2 groups based upon the wideness of the sellae opening (wide-opening group and narrow-opening group), and the patients’ age, sex, operating time, Knosp grade, tumor resection rate and side effects were evaluated. As a result, tumor resection rates were significantly higher in wide-opening group compared with the narrow-opening group. This finding suggests that wide opening of the sellae floor contributes to extensive resection of pituitary adenoma. In this study, as a limitation, grouping was performed chronologically (recently cases were grouped in the wide-opening group), so that the operators’ learning curve could be a confounder. Further investigations, including a prospective study, should be conducted to confirm these findings.

Journal

Journal of Nihon University Medical Association

Journal of Nihon University Medical Association 78 (6), 353-358, 2019-12-01

NIHON UNIVERSITY MEDICAL ASSOCIATION

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