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Article: Combined simultaneous transcranial and transsphenoidal resection of large-to-giant pituitary adenomas

TitleCombined simultaneous transcranial and transsphenoidal resection of large-to-giant pituitary adenomas
Authors
KeywordsComplications
Craniotomy
Pituitary adenoma
Surgical approach
Transsphenoidal
Issue Date2011
PublisherSpringer-Verlag Wien. The Journal's web site is located at http://www.springer.at/acta_neuro
Citation
Acta Neurochirurgica, 2011, v. 153 n. 7, p. 1401-1408 How to Cite?
AbstractBackground: While large-to-giant pituitary adenomas (PAs) may be safely removed by experienced surgeons through a single route, the procedure is technically challenging. We present the outcome of a simultaneous combined transcranial and transsphenoidal approach and discuss its applications. Methods: A retrospective review was conducted on 12 consecutive patients. Surgical complications, visual and endocrinological functions, and tumour control were reviewed. Results: There were four men and eight women, with a mean age of 47.6 years. All but one patient had non-functioning PAs. The mean tumour height was 4.1 cm (range: 2.3-5.5). The predominant presenting symptoms were visual field loss in eight patients, headache in three patients and mental confusion in one patient. There was no operative mortality. Post-operative cerebrospinal fluid leakage occurred in one patient. Five of the eight patients who presented with visual field loss achieved full recovery, and three had partial improvement. Two patients developed permanent diabetes insipidus after surgery. Panhypopituitarism occurred in one patient. Gross total removal (GTR) was achieved in five, and subtotal removal (STR) in seven patients. Seven patients received post-operative external irradiation. All patients who had GTR remained tumour-free and all those with STR had stable diseases after a mean follow-up period of 53.1 months (range: 14.1-92.1). Conclusion: The simultaneous 'above and below' approach is a safe and effective surgical strategy for large-to-giant PAs, particularly when expertise in endoscopic transsphenoidal surgery is unavailable. Its use, however, should be limited to a carefully selected group of patients, and tailored to individual user's expertise and experience. © 2011 The Author(s).
Persistent Identifierhttp://hdl.handle.net/10722/134482
ISSN
2015 Impact Factor: 1.617
2015 SCImago Journal Rankings: 0.833
PubMed Central ID
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLeung, GKKen_HK
dc.contributor.authorLaw, HYen_HK
dc.contributor.authorHung, KNen_HK
dc.contributor.authorFan, YWen_HK
dc.contributor.authorLui, WMen_HK
dc.date.accessioned2011-06-17T09:21:42Z-
dc.date.available2011-06-17T09:21:42Z-
dc.date.issued2011en_HK
dc.identifier.citationActa Neurochirurgica, 2011, v. 153 n. 7, p. 1401-1408en_HK
dc.identifier.issn0001-6268en_HK
dc.identifier.urihttp://hdl.handle.net/10722/134482-
dc.description.abstractBackground: While large-to-giant pituitary adenomas (PAs) may be safely removed by experienced surgeons through a single route, the procedure is technically challenging. We present the outcome of a simultaneous combined transcranial and transsphenoidal approach and discuss its applications. Methods: A retrospective review was conducted on 12 consecutive patients. Surgical complications, visual and endocrinological functions, and tumour control were reviewed. Results: There were four men and eight women, with a mean age of 47.6 years. All but one patient had non-functioning PAs. The mean tumour height was 4.1 cm (range: 2.3-5.5). The predominant presenting symptoms were visual field loss in eight patients, headache in three patients and mental confusion in one patient. There was no operative mortality. Post-operative cerebrospinal fluid leakage occurred in one patient. Five of the eight patients who presented with visual field loss achieved full recovery, and three had partial improvement. Two patients developed permanent diabetes insipidus after surgery. Panhypopituitarism occurred in one patient. Gross total removal (GTR) was achieved in five, and subtotal removal (STR) in seven patients. Seven patients received post-operative external irradiation. All patients who had GTR remained tumour-free and all those with STR had stable diseases after a mean follow-up period of 53.1 months (range: 14.1-92.1). Conclusion: The simultaneous 'above and below' approach is a safe and effective surgical strategy for large-to-giant PAs, particularly when expertise in endoscopic transsphenoidal surgery is unavailable. Its use, however, should be limited to a carefully selected group of patients, and tailored to individual user's expertise and experience. © 2011 The Author(s).en_HK
dc.languageengen_US
dc.publisherSpringer-Verlag Wien. The Journal's web site is located at http://www.springer.at/acta_neuroen_HK
dc.relation.ispartofActa Neurochirurgicaen_HK
dc.rightsThe original publication is available at www.springerlink.com-
dc.rightsThe Author(s)-
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subjectComplicationsen_HK
dc.subjectCraniotomyen_HK
dc.subjectPituitary adenomaen_HK
dc.subjectSurgical approachen_HK
dc.subjectTranssphenoidalen_HK
dc.titleCombined simultaneous transcranial and transsphenoidal resection of large-to-giant pituitary adenomasen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0001-6268&volume=153&issue=7&spage=1401&epage=1408&date=2011&atitle=Combined+simultaneous+transcranial+and+transsphenoidal+resection+of+large-to-giant+pituitary+adenomas-
dc.identifier.emailLeung, GKK: gilberto@hkucc.hku.hken_HK
dc.identifier.authorityLeung, GKK=rp00522en_HK
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1007/s00701-011-1029-yen_HK
dc.identifier.pmid21533660-
dc.identifier.pmcidPMC3111555-
dc.identifier.scopuseid_2-s2.0-79959571819en_HK
dc.identifier.hkuros185904en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-79959571819&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume153en_HK
dc.identifier.issue7en_HK
dc.identifier.spage1401en_HK
dc.identifier.epage1408en_HK
dc.identifier.isiWOS:000292924700006-
dc.publisher.placeAustriaen_HK
dc.identifier.scopusauthoridLeung, GKK=35965118200en_HK
dc.identifier.scopusauthoridLaw, HY=46062272000en_HK
dc.identifier.scopusauthoridHung, KN=37077257300en_HK
dc.identifier.scopusauthoridFan, YW=7403492523en_HK
dc.identifier.scopusauthoridLui, WM=7101851125en_HK
dc.identifier.citeulike9263071-

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