Combined endoscopic endonasal transsphenoidal and microscopic transcranial approaches for the primary resection of giant pituitary adenomas - 19/09/25
Highlights |
• | Combined endoscopic endonasal and microscopic transcranial approaches allow single-stage resection of giant pituitary adenomas. |
• | Total resection achieved in 90% of cases (9/10) with minimal postoperative complications. |
• | Dual-approach reduces residual tumors, avoids staged surgeries, and lowers complication risks. |
• | Effective for multilobulated and dumbbell-shaped tumors invading critical neurovascular structures. |
• | Multidisciplinary teamwork ensures safe execution and robust skull base reconstruction. |
Abstract |
Aim |
Giant pituitary adenomas often present as dumbbell-shaped or multilobulated, presenting significant challenges for surgical treatment. Currently, there is no universally recognized optimal surgical strategy for choosing a dual-scope approach for primary or staged resection. This study aims to present surgical cases and clinical experience with endoscopic endonasal transsphenoidal combined with microscopic transcranial approaches for the primary resection of giant pituitary adenomas.
Material and methods |
Ten patients with giant pituitary adenomas underwent one-stage surgical resection using endoscopic endonasal transsphenoidal combined with microscopic transcranial approaches. Imaging findings and treatment outcomes were subsequently reviewed.
Results |
All patients underwent single-stage tumor resection using endoscopic endonasal transsphenoidal combined with microscopic transcranial approaches. Nine patients underwent total resection, while one patient underwent near-total resection. Postoperatively, visual acuity improved in six patients, while four patients experienced no significant change in visual acuity. One patient experienced cerebrospinal fluid leakage postoperatively and underwent a second repair. One patient developed a postoperative infection, and one developed hypopituitarism. No deaths or serious complications occurred.
Conclusion |
Single-stage resection of giant pituitary adenomas using endoscopic endonasal transsphenoidal combined with microscopic transcranial approaches facilitates complete tumor resection, minimizes the need for residual tumor and staged surgeries, and reduces postoperative bleeding due to tumor remnants. This method improves the total resection rate and reduces postoperative complications and mortality, demonstrating significant effects and clinical application value, making it worthy of promotion.
Le texte complet de cet article est disponible en PDF.Keywords : Multilobulated pituitary tumor, Dumbbell pituitary tumor, Giant pituitary adenomas, Dual-mirror combination
Abbreviations : EETS, TMS, CSF
Plan
Vol 71 - N° 6
Article 101727- novembre 2025 Retour au numéro
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