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Microscopic surgery for pituitary adenomas to preserve the pituitary gland and stalk

  • Authors:
    • Hao‑Yu Li
    • Cheng‑Yuan Feng
    • Chi Zhang
    • Jun Su
    • Jian Yuan
    • Yuanyang Xie
    • Yiwei Liao
    • Xianrui Yuan
    • Qing Liu

  • View Affiliations

  • Published online on: January 19, 2017     https://doi.org/10.3892/etm.2017.4063
  • Pages: 1011-1016
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Abstract

Surgery is the primary treatment of choice for all symptomatic pituitary adenomas except prolactinomas. Common postoperative complications include endocrinopathies, vision impairment and cerebrospinal fluid leak. The present study assessed 153 continuous microscopic surgeries for pituitary adenomas performed by an author of the present study between 2010 to 2014. Patients underwent either transphenoidal or transcranial surgery depending on their individual tumor characteristics. Five typical cases are presented in the present study and intraoperative identification and preservation of the gland and stalk were discussed. Postoperative complications were analyzed and compared with the literature. In the present analysis, 90.2% patients received transphenoidal surgery, and the rest underwent transcranial operation. Gross total resection was achieved in 81.2% patients in the transphenoidal group and 46.7% patients in the transcranial group. No new hypopituitarism or worsening of the pre‑existing pituitary dysfunctions was detected. The most common postoperative endocrinopathy was diabetes insipidus (transphenoidal group, 4.3%; transcranial group, 26.7%). All patients were fully recovered prior to discharge. The findings indicated the importance of pituitary gland and stalk preservation during the microscopic surgery to minimize postoperative morbidity and mortality, without compromising the extent of tumor resection. Based on preoperative imaging characteristics and intraoperative observations, surgeons should try all possible means to preserve the pituitary stalk and gland during surgery in order to minimize postoperative endocrinopathies and improve quality of life.
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March-2017
Volume 13 Issue 3

Print ISSN: 1792-0981
Online ISSN:1792-1015

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Spandidos Publications style
Li HY, Feng CY, Zhang C, Su J, Yuan J, Xie Y, Liao Y, Yuan X and Liu Q: Microscopic surgery for pituitary adenomas to preserve the pituitary gland and stalk. Exp Ther Med 13: 1011-1016, 2017.
APA
Li, H., Feng, C., Zhang, C., Su, J., Yuan, J., Xie, Y. ... Liu, Q. (2017). Microscopic surgery for pituitary adenomas to preserve the pituitary gland and stalk. Experimental and Therapeutic Medicine, 13, 1011-1016. https://doi.org/10.3892/etm.2017.4063
MLA
Li, H., Feng, C., Zhang, C., Su, J., Yuan, J., Xie, Y., Liao, Y., Yuan, X., Liu, Q."Microscopic surgery for pituitary adenomas to preserve the pituitary gland and stalk". Experimental and Therapeutic Medicine 13.3 (2017): 1011-1016.
Chicago
Li, H., Feng, C., Zhang, C., Su, J., Yuan, J., Xie, Y., Liao, Y., Yuan, X., Liu, Q."Microscopic surgery for pituitary adenomas to preserve the pituitary gland and stalk". Experimental and Therapeutic Medicine 13, no. 3 (2017): 1011-1016. https://doi.org/10.3892/etm.2017.4063