Karki Mohan, Sun Jinzhang, Yadav Chandra Prakash, Zhao Bing
The Second Affiliated Hospital of Anhui Medical University, China; Department of Neurosurgery, Skull Base Tumor Research Center, Anhui Medical University, Hefei 230601, Anhui, China.
The Second Affiliated Hospital of Anhui Medical University, China; Department of Neurosurgery, Skull Base Tumor Research Center, Anhui Medical University, Hefei 230601, Anhui, China.
J Clin Neurosci. 2017 Oct;44:310-314. doi: 10.1016/j.jocn.2017.07.015. Epub 2017 Aug 1.
To evaluate surgical outcomes and complications of patients who underwent microscopic trans-sphenoidal surgery (MTS) for large and giant pituitary adenomas (PAs). A retrospective study of electively operated cases of PA over a six year period was performed. Surgical outcomes and complications of 64 patients with large PAs (≥3cm) and 59 patients with giant PAs (>4cm), who underwent MTS at same period, were reviewed. Medical reports of all selected patients were assessed to collect demographic information such as age, sex, clinical symptoms, PA size, the extent of PA extension and resection, outcomes and complications. Patients with large PAs had improvement in visual improvement (78.1%; 50/64), gross total resection (84.4%; 54/64) compared to patients with giant PAs who had improvement in visual (71.2%; 42/59) and gross total resection (74.6%; 44/59). The rate of CSF leakage was 7.8% and 23.7% for large and giant PAs (p=0.0399). After a mean follow-up period of 40.8 (6-75) months, 10 (15.6%) patients with large PAs experienced tumor recurrence, while 2 giant PA patients (3.4%) experienced tumor recurrence after a mean follow-up period of 40.6 (3-70) months (p=0.0314). Resection of both large and giant pituitary adenomas by microscopic trans-sphenoidal surgery may be safe and effective surgical technique with low morbidity and mortality.
评估接受显微镜下经蝶窦手术（MTS）治疗大及巨大垂体腺瘤（PA）患者的手术效果及并发症。对六年期间择期手术的PA病例进行回顾性研究。回顾同期接受MTS的64例大PA（≥3cm）患者和59例巨大PA（>4cm）患者的手术效果及并发症。评估所有入选患者的医疗报告，收集年龄、性别、临床症状、PA大小、PA扩展及切除范围、手术效果和并发症等人口统计学信息。与巨大PA患者相比，大PA患者的视力改善率（78.1%；50/64）、全切除率（84.4%；54/64）更高，巨大PA患者的视力改善率为71.2%（42/59），全切除率为74.6%（44/59）。大及巨大PA的脑脊液漏发生率分别为7.8%和23.7%（p=0.0399）。平均随访40.8（6 - 75）个月后，10例（15.6%）大PA患者出现肿瘤复发，而2例巨大PA患者在平均随访40.6（3 - 70）个月后出现肿瘤复发（p=0.0314）。显微镜下经蝶窦手术切除大及巨大垂体腺瘤可能是一种安全有效的手术技术，发病率和死亡率较低。
