Observation on curative effect of two kinds of surgical methods of pituitary adenoma resection

Abstract

Objective: To compare the clinical data of pituitary adenoma resection with pterional approach and transsphenoidal approach, to analyze its advantages and disadvantages, and to provide reference for clinical diagnosis and treatment. Methods: From March 2010 to March 2014, 54 patients with pituitary adenoma were randomly divided into microscopy pterional group (31 cases) and microscopy nasal sphenoid sinus group (23 cases). Using a microscope under the pterional approach and a single nasal sphenoid sinus approach to the surgical operation of the microscope. The results showed that the operation time, intraoperative blood loss, hospitalization time, effective resection rate and postoperative complications (mainly after a transient diabetes insipidus and transient electrolyte disorder) were observed. Hormone levels and the patient's 1-year follow-up results of the comparison. Results: There was no significant difference in the clinical data between the two groups. The average operative time (121.3 ± 19.4) min in the pterional group was significantly higher than that in the nasal sphenoid sinus group (78.5 ± 7.8) mL compared with the nasal sphenoid sinus group (50.3 ± 3.2) mL, statistically significant (P <0.05). There was no significant difference in the effective resection rate (91.3% vs 93.5%, P> 0.05), and the postoperative complications (including one hyperthyroidism and transient electrolyte imbalance) occurred no significant difference. All patients 1 year follow-up results can be seen, the two groups of long-term efficacy are better. Comparison between different type of tumors showed that there were some changes when pterional pterional and transphenoidal pre-surgery and post-surgery, secretion of PRL are [(387.3 ± 100.8) ng / mL vs (145.3 ± 27.4) ng / mL] and [(390.2±133.7) ng/ml vs (148.4±57.2) ng/ml]、GH [(63.4±5.7) ng/ml vs (10.6±2.4) ng/ml] and [(65.6±6.2) ng/ml vs (12.4±1.6)ng/ml]、ACTH[(202.9±73.7)ng/l vs (38.5±4.6) ng/l] and [(206.8±78.6) ng/l vs (35.6±2.5) ng/l], the difference was significant (P <0.05). There was no significant difference between the two groups (P> 0.05). Conclusion: There is no significant difference in the curative effect of two groups of surgical treatment of pituitary adenoma. The operation time and operation blood loss of  pituitary adenoma resection are superior to those of pterional infusion, which is minimally invasive, safe and effective, the clinical efficacy of the exact, worthy of further promotion.