Role of Endoscopic Assisted Microsurgery for Pituitary Tumors
Keywords:
Endoscopic, microsurgery, pituitary tumors, Gross tumor removal, visual field.Abstract
Objective: To determine the outcome of endoscopic assisted microsurgery for pituitary tumors in terms of gross tumor removal and visual field improvement.
Materials and Methods: This Descriptive case series conducted at Department of Neurosurgery, Lahore General Hospital Lahore over a period of six months from July 2012 to December 2012. Sixty five patients were included through non-probability purposive sampling technique. All cases of pituitary tumor diagnosed on MRI/CT scan of either gender having age 18 – 80 years and patients with recurrent cases, sellar and with suprasellar extension (assessed on CT and MRI findings). Informed consent was taken from the patients. All laboratory tests were done in hospital laboratory and reported by hospital pathologist Shaukat Khanum Memorial Hospital Lahore. Pre- and post-operative visual field status (at least 3 months after surgery) was analyzed. Surgery was performed by a single team of surgeons. Surgical procedure involves introduction of 4-mm to 2.7mm endoscope to visualize the sphenoethmoid recess. The bilateral sphenoid Ostia are entered. The posterior nasal septum was incised at middle turbinate and it was patients resected. All the data was entered and analyzed by using SPSS 20. Fre-quency and percentages were calculated for all qualitative variables like gross removal rate and visual filed improvement.
Results: The mean age of the patients was 50.46 ± 17.80 years. There were 64.62% male patients and 35.38% female patients. Gross removal of tumor was observed in 56 (86.2%) and visual field improvement was found in 92.31% patients. 56 patients were those in which gross removal of tumor was observed in which 34 were males and 22 were females, similarly in 9 patients them was subtotal resection of tumor in which 8 were males and only 1 was female.
Conclusion: In this study, gross removal of tumor as well as visual field improvement was found in maximum number of patients and it is concluded that endoscopic assisted microsurgery for pituitary tumors is a better technique for such surgeries.
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