In this retrospective study the authors attempted to find out long-term outcomes after pituitary macroadenoma resection via the endonasal endoscopic transsphenoidal route. Eighty of the 162 patients operated on met the study criteria of clinical and radiological follow-up for at least five years after resection. Seven patients who had grossly complete resection were found to have recurrences with a mean time to recurrence of 53 months. The authors found that patients with Knosp grade 0-2 tumours and tumour volumes <10 cm3 were significantly more likely to have received a grossly complete resection compared to patients with Knosp grade 3 to 4 tumours or tumours with volumes >10 cm3. Of the 23 patients who had sub-total resection, 11 progressed radiographically and three were found to have symptomatic progression. Recurrent or residual tumours were treated with either repeat surgery or gamma knife radiosurgery. The authors found that the rates of grossly complete resection, incidence of new hypopituitarism, and postoperative complications were similar to those in published literature on endoscopic and microscopic pituitary adenoma resection. The article however does not provide the author’s outcome results following microscopic versus endonasal endoscopic resection.

Long-term results of endonasal endoscopic transsphenoidal resection of nonfunctioning pituitary macroadenomas.
Dallapiazza RF, Grober Y, Starke RM, et al.
NEUROSURGERY
2015:76:42-53.
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Gauri Mankekar

Neurotology, LSUHSC, New Orleans, LA, USA.

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