INTRAOPERATIVE ENDOVIDEOMONITORING IN TRANSSPHENOIDAL SURGERY OF PITUITARY ADENOMAS
V.Yu. Cherebillo, B.V. Gaidar, Yu.L. Shcherbuk, V.R. Gofman, A.V. Polezhaev
The analysis of results of surgical treatment of pituitary adenomas in the Clinic of Neurosurgery of the Medicomilitary Academy is given. There were 247 patients with pituitary adenomas operated during the last decade; a transsphenoidal approach was used in 167 of them. A method of transsphenoidal endoscopic surgery of pituitary adenomas proposed in Russia for the first time not long ago is aimed at optimization of an operative approach. This method allows to improve results of complex treatment, to verify efficacy of an operation and to minimize trauma caused by it.
Transsphenoidal removal of pituitary adenomas with application of intraoperative endoscopic monitoring was made in 56 patients. The Concept rigid endoscope (Sweden) with a diameter of 4mm and an angular view of 30 degrees, the BF-P-30 Olympus flexible guided endoscope (Japan) with a diameter of 6 mm, Karl Storz (Germany) and Zenit (Russia) endovideocameras, the CLE-10 Olympus halogen lamp (Japan) and the Sony videomonitor were used.
A transsphenoidal endoscopic intervention was a modification of standard transseptal approach to the Turkish saddle according to Girsh. Its results were monitored and recorded. CT and/or MRI examinations of the chiasmal-sellar area of the brain and study of blood hormones were carried out before and after the operation.
The results of operative treatment of pituitary adenomas make it possible to recommend introduction of the method under discussion into clinical practice of specialized departments and neurosurgical clinics.