Endoscopic Endonasal Transsphenoidal Surgery in Recurrent and Residual Pituitary Adenomas: Technical Note

P. Cappabianca; A. Alfieri; A. Colao; L. M. Cavallo; M. Fusco; C. Peca; G. Lombardi; E. de Divitiis

doi:10.1055/s-2000-8814

min - Minimally Invasive Neurosurgery, Table of Contents

Minim Invasive Neurosurg 2000; 43(1): 38-43
DOI: 10.1055/s-2000-8814

ORIGINAL PAPER

Georg Thieme Verlag Stuttgart · New York

Endoscopic Endonasal Transsphenoidal Surgery in Recurrent and Residual Pituitary Adenomas: Technical Note[1]

P. Cappabianca¹ , A. Alfieri¹ , A. Colao² , L. M. Cavallo¹ , M. Fusco¹ , C. Peca¹ , G. Lombardi² , E. de Divitiis¹

Departments of ¹ Neurosurgery and
² Molecular and Clinical Endocrinology and Oncology, “Federico II” University, School of Medicine, Naples, Italy

Abstract

Despite a good cure rate after surgery, the recurrence rate in pituitary adenomas is globally high. The decision making in such cases can be problematic for the nature of the lesion, for the anatomic structures involved, for the different pharmacological, surgical, radiotherapeutic and radiosurgical options nowadays available. In the perspective of an improvement and refinement of the surgical procedure an endoscopic endonasal transsphenoidal approach to the pituitary was recently adopted in the Neurosurgical Department of the University of Naples. Its minimal invasiveness and its wider and direct anatomic control of the operative field has allowed a faster, greater and safer potential of tumour excision, with respect of the sphenoid, sellar and parasellar structures. The authors have examined the advantages provided by this technique in 12 patients with recurrent pituitary adenomas and in 2 craniopharyngiomas already treated via a transnasal transsphenoidal approach (TTA), where the anatomy of surgical field had been distorted by the first operation or the radiation therapy. They conclude that the endoscopic transsphenoidal re-operation might be considered the procedure of choice in case of recurrences and its easiness in such conditions could favour its larger use, before other more aggressive therapeutic solutions.

Key words:

Pituitary adenomas - Recurrences - Transsphenoidal surgery - Endoscopy

Full Text

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1 Presented at the 1^st Congress on Endoscope Assisted Microneurosurgery, Frankfurt (Germany), June 10 - 12, 1998.

Corresponding Author

Dr. Paolo Cappabianca

Department of Neurosurgery “Federico II” University, School of Medicine

Via S. Pansini, n° 5

80131 Naples

Italy

Phone: + 39-0 81-7 46 25 83

Fax: + 39-0 81-7 46 24 97/5 98 78 21

Email: cappabia@unina.it