OUTCOMES OF ENDOSCOPIC ENDONASAL TRANSSPHENOIDAL SURGERY FOR ACTH- SECRETING PITUITARY ADENOMAS AT VIET DUC HOSPITAL
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Abstract
Objective: To analyze results and complications of endoscopic transsphenoidal surgery in patients with ACTH- secreting pituitary adenomas. Methods: Retrospective and prospective study on 29 cases with ACTH- secreting pituitary adenomas (Cushing's disease) confirmed based on clinical features, laboratory findings, magnetic resonance imaging and treated by endoscopic transsphenoidal surgery at Viet Duc Hospital from October 2018 to September 2021. Results: The mean age was 42.7 years. There were 03 males (10%), and 26 females (90%), the ratio of female to male: 9/1. There were 6 cases of Microadenoma (20.7%), 23 cases of Macroadenoma (79.31%), the ratio of Microadenoma to Macroadenoma: 1/4. Surgical complications included transient diabetes insipidus (1 case), cerebrospinal fluid leak (1 case), symptomatic hyponatremia (5 cases) and all only needed medical treatment except 01 case of hydrocephalus treated by ventriculoperitoneal (VP) shunt. All Microadenoma cases were achieved gross total removal, twenty of 23 Macroadenoma cases were achieved subtotal removal. In total 9 cases admitted because of typical Cushing's syndrome, five of 6 cases of Microadenoma group and one of 3 cases of Macroadenoma group showed better changes in phenotype when re-examination after 3 months. Conclusion: endoscopic transsphenoidal pituitary surgery showed advantages such as safety and efficacy for ACTH- secreting pituitary adenomas treaaaatment.
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Keywords
ACTH- secreting pituitary adenomas, Cushing's disease, endoscopic transsphenoidal surgery
References
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