Introduction: Total resection of the tumor and good protection pituitary function were pursued in surgical treatment of pituitary adenoma. Since pseudocapsules were first identified in pituitary adenoma surgery in 1936, pseudocapsules and the value used in neurosurgery have been studied wordwide.
Methods: Assuming that pseudocapsules are ubiqity in pituitary adenomas, standard operation procedure in extrapseudocapsular resection of the pituitary adenoma was drew up by the department of neurosurgery of Nanjing Brain Hospital. The pseudocapsules were distinguished into three tough, soft and poor. Technical points and requirements were detaied one by one. From May 1, 2015 to April 30, 2016 in a single ward, there were 58 patients received the endonasal transsphenoidal surgery strictly in accordance with the standard. Retrospective analysis the operating time, extent of tumor resection, the incidence of diabetes insipidus and cerebrospinal fluid leakage, endocrine changes (preoperative, postoperative 1 day, 1 month, 3 months) and recovery rate of functional adenoma .
Results: Compared with the 51 patients received the endonasal transsphenoidal surgery from January 1, 2014 to December 31, 2014: the operating time is longer; the incidence of total resection and cerebrospinal fluid leakage are increased; the incidence of diabetes insipidus is decreased, the hormone level one day and one month after the surgery are better; the cure rate of endocrine of functional adenoma is higher.
Conclusions: Standard operation procedure in extrapseudocapsular resection of the pituitary adenoma is helpful to resect the adenoma totally and protect the function of the pituitary better.
Patient Care: Improve the understand of the disease and the surgical skills
Learning Objectives: By the conclusion of this session, participants should be able to: 1) Describe the importance of standard operation procedure in extrapseudocapsular resection of the pituitary adenoma, 2) Identify an effective way to improve the total removal rate.