Transsphenoidal pseudocapsule-based extracapsular resection for pituitary adenomas

• DOI: 10.1007/s00701-011-0961-1
• Publication Date: 2011-02-18T08:08:23Z
• Authors: Xin Qu; Jun Yang; Ji-Dong Sun; Cheng-Zhi Mou; Guo-Dong Wang; Tao Han; Yuan-Ming Qu; Min Wang; Guang-Ming Xu
• Keywords: Adenoma; Adult; Male; Microsurgery; Neoplasm, Residual; Adolescent; Sphenoid Sinus; Endoscopy; Middle Aged; Pituitary Hormones; Young Adult; 03 medical and health sciences; Postoperative Complications; Treatment Outcome; 0302 clinical medicine; Risk Factors; Humans; Female; Pituitary Neoplasms; Neoplasm Recurrence, Local; Aged; Hypophysectomy

In the past several years, increasing attention has been paid to the utility of a pseudocapsule in transphenoidal surgery for pituitary adenomas. However, prior studies focused more on the histological structure of the pseudocapsule and surgical technique. The objective of this study was to evaluate the overall therapeutic effectiveness of transsphenoidal pseudocapsule-based extracapsular resection for pituitary adenomas.Between January 2004 and October 2007, 78 patients with pituitary adenomas underwent transsphenoidal pseudocapsule-based extracapsular removal surgery (extracapsular resection group, ER group). During the same period, 64 patients underwent transsphenoidal intracapsular resection operations (intracapsular resection group, IR group).Complete resection rates were achieved in 90.6%, 84.6% and 65.5%, 52.6% of modified Hardy types II and III in the ER and IR groups, showing a significant difference (both P < 0.05). Statistical significance in the remission rates was also found between the two groups with modified Hardy types II and III, respectively (both P < 0.05). Complications occurred in 29.5% of the ER group and 26.6% of the IR group, with no difference between groups (P > 0.05). The recurrence rate of the ER group (2.56%) was lower than that of the IR group (14.06%).The transsphenoidal pseudocapsule-based extracapsular resection approach provides a more effective and safe alternative compared to the traditional intracapsular one because of its higher tumor removal and remission rates, and lower recurrence rate.