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Results of Resection of Giant Pituitary Adenomas through Endoscopic Endonasal Approach

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Background/Objective:  A minimally invasive surgical method is in use to create endoscopic transsphenoidal surgery. Because of the intricate dissection of the sellar region, surgical treatment of large pituitary adenomas is challenging. The study focused to determine the frequency of complications after endonasal endoscopic transsphenoidal resection of giant pituitary macroadenomas. Materials and Methods:  A descriptive case series study was conducted at the Neurosurgical Department of Lahore General Hospital, Lahore. A total of 70 patients fulfilling the selection criteria were enrolled. Major vascular injury was noted when there is an injury to the internal carotid artery or cavernous sinus. After discharge, patients were followed-up in OPD for 3 months. After 3 months, patients were evaluated for CSF leak and vision. The presence of complications was recorded. During surgery, operative time was noted. Results:  Mean age of patients was 55.7 ± 6.5 years. 45.71% of patients were male while the remaining 54.29% of patients were female Total of 41.43% of patients had disease < 2 years, whereas the duration of surgery was ? 3 hours in 64.3% of patients. A total 15.71% had complications which included diabetes insipidus (8.57%), infections (5.71%), pituitary dysfunction (4.29%), CSF leak (2.8%) and vascular injury (1.43%). The mortality rate was 1.43%. Conclusion:  The complication rate after endonasal endoscopic transsphenoidal resection of giant pituitary macroadenomas was high. Keywords:  Endonasal Endoscopic, Transsphenoidal Resection, Pituitary Macroadenomas, Complications
Title: Results of Resection of Giant Pituitary Adenomas through Endoscopic Endonasal Approach
Description:
Background/Objective:  A minimally invasive surgical method is in use to create endoscopic transsphenoidal surgery.
Because of the intricate dissection of the sellar region, surgical treatment of large pituitary adenomas is challenging.
The study focused to determine the frequency of complications after endonasal endoscopic transsphenoidal resection of giant pituitary macroadenomas.
Materials and Methods:  A descriptive case series study was conducted at the Neurosurgical Department of Lahore General Hospital, Lahore.
A total of 70 patients fulfilling the selection criteria were enrolled.
Major vascular injury was noted when there is an injury to the internal carotid artery or cavernous sinus.
After discharge, patients were followed-up in OPD for 3 months.
After 3 months, patients were evaluated for CSF leak and vision.
The presence of complications was recorded.
During surgery, operative time was noted.
Results:  Mean age of patients was 55.
7 ± 6.
5 years.
45.
71% of patients were male while the remaining 54.
29% of patients were female Total of 41.
43% of patients had disease < 2 years, whereas the duration of surgery was ? 3 hours in 64.
3% of patients.
A total 15.
71% had complications which included diabetes insipidus (8.
57%), infections (5.
71%), pituitary dysfunction (4.
29%), CSF leak (2.
8%) and vascular injury (1.
43%).
The mortality rate was 1.
43%.
Conclusion:  The complication rate after endonasal endoscopic transsphenoidal resection of giant pituitary macroadenomas was high.
Keywords:  Endonasal Endoscopic, Transsphenoidal Resection, Pituitary Macroadenomas, Complications.

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