Pituitary Adenoma Research Paper

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The surgery Pituitary adenoma has evolved from a craniotomy approaches toward less invasive approaches, over the last century. In the last twenty years, there is a solid growing evidence to support the use of endoscopic approach as an alternative approach for treatment of pituitary adenomas (8-12). Endoscopy can expand the surgeons’ performance of transsphenoidal surgery, improves visualization and facilitates removing tumors that could not be accessed before. Several authors have discussed the potential outcomes of the endoscopic technique. DeKlotz et al.(9) used a meta-analysis to reveal the superior rate of GTR (79% versus 65%, P < 0.0001) as well as the lower rates of CSF leak (5% versus 7%, P < 0.01), septal perforation (0% versus 5%) and …show more content…
It could occur during the exploration of diaphragmatic recesses, and most of these leaks may stop with no treatment. The incidence of CSF leak increases in patients who had previous surgical interventions, or in patients who have large pituitary adenoma with suprasellar extension. The risk of CSF leak is higher in macroadenomas than microadenomas [10], due to the fact that the surgeon works closer to the diaphragm sellae and the subarachnoid space in these cases. So, it is important to detect the tear in the diaphragma sella and/or arachnoid membrane during the surgery and seal it [14]. In this study, any intraoperative CSF leak was repaired intraoperatively as soon as it was detected by abdominal fat and sealed by fibrin glue. Postoperative CSF leak occurred in 2 patient (6.6%), 1 case endoscopic reexploration operation was done an leak point is define and reconstructed by fat and surgicell. the other case leak was minor and it stopped spontaneously after one week of conservative treatment in the form of dehydrating measures and lying flat in bed .table 3and 3a show complications in different published series and the current

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