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Japanese

Transsphenoidal Surgery for Pituitary Tumors from Microsurgery to the Endoscopic Surgery: Single Surgeon's Experience Yoshiyasu IWAI 1 , Masaki YOSHIMURA 1 , Aiko TERADA 1 , Kazuhiro YAMANAKA 1 , Naomi KOSHIMO 2 1Department of Neurosurgery,Osaka City General Hospital 2Department of Othorhinolaryngology,Osaka City General Hospital Keyword: endonasal , endoscopic surgery , microsurgery , pituitary , transsphenoidal pp.141-147
Published Date 2011/2/10
DOI https://doi.org/10.11477/mf.1436101345
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 We reviewed results of the surgical outcome of pituitary tumors treated via the transsphenoidal approach between January,1994 and January,2010 at our institution. This data included 100 patients (124 procedures) treated through the sublabial transsphenoidal approach and 45 patients (54 procedures) treated through the endoscopic endonasal (bilateral nostrils) transsphenoidal approach performed by a single surgeon. The extent of tumor removal was significantly improved with endoscopic surgery; adjuvant gamma knife radiosurgery was needed for 65% of patients undergoing microsurgery vs. 30% for patients who had endoscopic surgery (p<0.0001). Patients who underwent endoscopic surgery had less intraoperative blood loss (mean volume: 100 mL for microsurgery patients vs. 30 mL for endoscopic surgery patients,p<0.0001),less pain,and less need for postoperative hormone replacement therapy (19% for microsurgery patients vs. 6% for endoscopic surgery patients; p<0.05). CSF leakage and meningitis were experienced in one microsurgery patient (1%) and one endoscopic surgery patient (2.2%). Endoscopic surgery is a reasonable alternative to microsurgery and our experience supports the concept that an otolaryngologist/neurosurgeon team skilled in endoscopic techniques and pituitary surgery can safely make the transition from microsurgery to endoscopic surgery.


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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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