Efficacy of Bilateral Nostril Transnasal-Sphenoidal Approach Resection Under Neuroendoscopy for the Treatment of Pituitary Adenoma
Objective To analyze the efficacy and safety of neuroendoscopic bilateral nostril transnasal-sphenoidal approach in the treatment of pituitary adenoma.Methods This study retrospectively analyzed the clinical data of 89 patients with pituitary adenoma admitted to Zhumadian TCM Hospital from January 2019 to May 2023.According to different surgical approaches,they were divided into control group(43 cases,unilateral nostril transnasal-sphenoidal approach under neuroendoscope)and observation group(46 cases,bilateral nostril transnasal-sphenoidal approach under neuroendoscope).The clinical data of the patients were analyzed,and the perioperative indexes,tumor resection rate,hormone level and complications were compared between the two groups.Results The operating time and postoperative hospitalization time in the observation group were longer than those in the control group,intraoperative bleeding volume was more than that in the control group(P＜0.05).Comparison of total resection rate subtotal resection rate and partial resection rate between two groups of microadenomas/macroadenomas had no statistically difference(P＞0.05).The total resection rate and secondary resection rate of giant adenomas in the observation group were higher than those in the control group(P＜0.05).The levels of prolactin(PRL),growth hormone(GH),and adrenocorticotropic hormone(ACTH)in the two groups were reduced one week after surgery compared to before surgery(P＜0.05),but PRL,GH,and ACTH levels between the two groups before and 1 week after surgery had no statistically difference(P＞0.05).The incidence of complications between the two groups had no statistically difference(P＞0.05).Conclusion Both approaches have good therapeutic effect and safety for microadenomas/macroadenomas.Although the operation time,intraoperative blood loss and postoperative recovery time of endoscopic bilateral nostril transnasal-sphenoidal approach are slightly higher than those of unilateral nostril approach,for macroadenomas,bilateral nostril transnasal-sphenoidal approach has a higher degree of resection.
万方数据
维普
