Combined endoscopic transsphenoidal and tubular retractor-assisted transventricular approach for giant pituitary adenomas

xlomafota13 shared this article with you from Inoreader Combined endoscopic transsphenoidal and tubular retractor-assisted transventricular approach for giant pituitary adenomas Via leak of cerebrospinal fluid World Neurosurg. 2021 Sep 6:S1878-8750(21)01323-1. doi: 10.1016/j.wneu.2021.08.135. Online ahead of print. ABSTRACT BACKGROUND: Surgical resection remains the standard treatment for most giant pituitary adenomas (GPAs). The selected surgical approach for these complex lesions depends mainly on their extension. Single approaches may be limited in some cases presenting with invasion into multiple compartments, thereby limiting extent of resection. METHODS: We report a series of patients with GPA operated on through a combined approach involving an endoscopic endonasal transsphenoidal approach and a tubular retractor-assisted transventricular approach, describing the technique, its indications, limitations, and outcomes. Baseline and postoperative clinical, functional, and morphological variables were documented up until each patient's last follow-up visit. RESULTS: Five patients harbouring tumours extending into the third and latera l ventricles were included. Mean extent of resection was 94.6%. Mean follow-up was 39.4 months. One patient presented with a growth hormone-secreting GPA, who achieved remission after repeat resection during follow-up. There were no intraoperative complications, and one patient required reoperation for cerebrospinal fluid leak repair. One patient received adjuvant radiotherapy, and three patients remained stable requiring no additional treatment. All patients maintained an adequate postoperative functional status. CONCLUSIONS: The combined approach herein described may be a safe and effective option for some patients with GPAs extending into the third and lateral ventricles. An adequate patient selection is mandatory to exploit the benefits of each individual approach. PMID:34500097 | DOI:10.1016/j.wneu.2021.08.135 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.