Endoscopic endonasal transsphenoidal surgery for large pituitary adenomas

Objective To evaluate the effect of removing large pituitary adenomas(LPA) by endoscopic technique via endonasal transsphenoidal approach. Methods A total of 38 patients suffering from LPA was performed with endoscopic endonasal transsphenoidal surgery from December of 2003 to July of 2004.Results Gross removal of tumors in 33 cases (86.8%) and subtotal removal in 3 cases (7.9%) were achieved. Partial removal was carried out in the remaining 2 cases (5.3%) with fibrous or dumbbell shaped adenomas. No death was found postoperatively. A median of 3 months' follow up in 31 patients (81.6%) revealed that 29 cases( 93.3% ) with preoperative diminished acuity had got postoperative improvement, no change in 2 cases (6.4%), and none aggravation could be found postoperatively. Among the 30 patients with preoperative visual field defects, postoperative recovery was achieved in 28 cases (93.3%) and improvement in 2 cases (6.7%). Conclusion Featured by perfect surgery vision, minimal invasion and less postoperative complications, endoscopic technique via endonasal transsphenoidal apporoach is a safe and effective method for the treatment of LPA.