Surgical Technique and Efficacy Analysis of Extra-pseudocapsular Transnasal Transsphenoidal Surgery for Pituitary Microprolactinoma

Wan XY, Li LH, Chen J, Wang JW, Liu YC, Huang YM, Shu K, Buchfelder M, Fahlbusch R, Lei T (2022)

Publication Type: Journal article

Publication year: 2022

Journal

Current Medical Science Huazhong University of Science and Technology

DOI: 10.1007/s11596-022-2678-1

Abstract

Objective: To elucidate the role of transsphenoidal surgery in the treatment of pituitary microprolactinoma. Methods: The clinical data of 107 prolactinoma cases treated by extra-pseudocapsular transnasal transsphenoidal surgery (ETTS) for different indications in our department since 2011 was retrospectively analyzed. Results: The most common indication was the ineffectiveness of oral medication (41.1%), followed by the personal willingness of the patient (35.5%), and 20.6% of the patients were young women with clear tumor boundaries. The pseudocapsule was not observed in 63 cases (58.9%), incomplete pseudocapsule was observed in 26 cases (24.3%), and complete pseudocapsule in 18 cases (16.8%). A total of 97 patients (90.7%) obtained 1-year post-operation remission. According to the relative location of the adenoma and pituitary gland on the MRI scan, 46 patients were classified into a central type, 59 a lateral type, and 2 a supra-pituitary type. Two patients developed hypogonadism, one patient developed hypocortisolism, and one patient developed post-operative hypothyroidism. Two patients were administrated with hormone replacement treatment, and the treatment was stopped within one week. There was no permanent hypopituitarism. Further investigation demonstrated that the adenoma types could affect the remission rates of hyperprolactinemia and gross total resection rate in microprolactinoma. Conclusion: ETTS was an effective treatment for pituitary microprolactinomas. This could be the first choice for patients who presented enclosed adenoma on the MRI and were potentially curable in a preoperative evaluation. Maximal safe removal of the adenoma by ETTS with the aim to increase the sensitivity of the drugs was also recommended for patients with invasive dopamine agonist resistant prolactinomas and patients with difficulty in childbirth.

Authors with CRIS profile

Michael Buchfelder Lehrstuhl für Neurochirurgie

Involved external institutions

Huazhong University of Science & Technology CN China (CN) International Neuroscience Institute GmbH (INI) DE Germany (DE)

How to cite

APA:

Wan, X.-Y., Li, L.-H., Chen, J., Wang, J.-W., Liu, Y.-C., Huang, Y.-M.,... Lei, T. (2022). Surgical Technique and Efficacy Analysis of Extra-pseudocapsular Transnasal Transsphenoidal Surgery for Pituitary Microprolactinoma. Current Medical Science. https://dx.doi.org/10.1007/s11596-022-2678-1

MLA:

Wan, Xue-Yan, et al. "Surgical Technique and Efficacy Analysis of Extra-pseudocapsular Transnasal Transsphenoidal Surgery for Pituitary Microprolactinoma." Current Medical Science (2022).

BibTeX: Download