Introduction: The trans-sphenoid approach for the recurred or residual pituitary adenoma after microscopic resection is challenging. We reported the outcomes of endoscopic endonasal approach (EEA) for the recurred or residual pituitary adenomas.
Methods: From February 2010 to February 2013, EEA was performed for 6 recurred and 24 growing residual pituitary adenomas after microscopic trans-sphenoid resection. Twenty seven (90%) patients had a clinically non-functioning pituitary adenoma. Twenty four (80%) patients suffered from the visual disturbance related with the tumor growth. The clinical features and surgical outcomes were analyzed from the ophthalmological, endocrinological and oncological aspects
Results: The mean tumor volume was 11.7 cm3 and the gross total resection was achieved in a half of patients. The mean and median resection rates were 90% and 99%, respectively. The visual symptom was improved in 19 (79%) out of 24 patients with subjective visual symptoms and no visual deterioration was reported in all patients. The endocrinological cure was achieved in all three functioning pituitary adenomas. The post-EEA follow-up endocrinological examination revealed a new endocrinological deficit in a patient. Two patients required the antibiotics management for the post-operative meningitis.
Conclusions: The EEA could be the valuable treatment option for the recurred or growing residual pituitary adenomas after microscopic trans-sphenoid approach with the acceptable outcome.
Patient Care: The degree of tumor removal could be improved by the EEA for recurred or residual pitutiary adenomas. The risk of surgery might be reduced with this technique.
Learning Objectives: Advantages and risks in the surgical managment of recurred or residual pitutiary adenomas