Analysis of the improvement of treatment effects by adjusting surgical strategies for pituitary neuroendocrine tumors:a report of 3 504 cases
Objective To analyze the effect of adjusting the surgical strategy of pituitary neuroendocrine tumors(PitNET)on improving the treatment effect.Methods The clinical data of 3 504 PitNET patients who underwent surgical treatment at the Neurosurgery Center of Beijing Tiantan Hospital,Capital Medical University from January 2008 to December 2022 were retrospectively analyzed.During this period,the surgical strategy was adjusted based on literature reports and independent exploration.Patients admitted from January 2008 to December 2016(Group A)were treated with the pre-adjusted surgical strategy,and patients admitted from January 2017 to December 2022(Group B)were treated with the adjusted surgical strategy.The surgical treatment effects and postoperative complications of the two groups of patients were compared and analyzed.Results There were 1 394 patients in group A and 2 110 patients ingroup B.The total tumor resection rate of group B[91.0％(1 920/2 110)vs.73.4％(1 023/1 394)],and the postoperative visual acuity improvement rate[89.6％(509/568)vs.69.0％(260/377)]were higher than those in group A(both P＜0.001),while the incidence of postoperative cerebrospinal fluid leakage[0.5％(10/2 110)vs.5.1％(71/1 394)],and the incidence of postoperative intracranial infection[2.4％(50/2 110)vs.4.2％(58/1 394)],and the postoperative lumbar catheterization rate[0.3％(6/2 110)vs.3.6％(50/1 394)]were lower than those in group A(all P＜0.05).Among them,the biological cure rate of patients with functional PitNET in group A after surgery was lower than that in group B[52.3％(203/388)vs.83.6％(475/568),P＜0.001].Conclusion Improvement of PitNET surgical strategy can significantly improve the effect of surgical treatment and reduce the occurrence of related complications.
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