The application of sellar dural suture technique in endoscopic transsphenoidal pituitary adenoma resection

Abstract

Objective To summarize the experience of sellar dural suture technique in endoscopic transsphenoidal pituitary adenoma resection. Methods From October 2018 to November 2019, 25 patients with pituitary adenomas who underwent endoscopic transsphenoidal pituitary adenoma resection were selected. All of the 25 patients had cerebrospinal fluid (CSF) leakage during operation and underwent dural suture at the sellar floor. Results The total tumor resection rate was 100% (25/25). The dural suture time was 24 min in average, and the later 15 cases had an average time of 15 min. The successful rate of CSF leakage repair was 100% (25/25). There were no postoperative CSF leakage and lumbar cistern drainage. Two cases were repaired with nasal mucosal flap because of dural defect. No perioperative infection or other complications occurred. The average follow⁃up period was 9.62 months. One case of prolactinoma recurred and there was no delayed CSF leakage or death case. Conclusions Sellar dural suture is a safe and reliable technique to reduce the incidence of CSF leakage after pituitary adenoma surgery. It can reduce the application of autologous fat transplantation, autologous fascia transplantation and pedicled nasal septum mucosal flap, so as to reduce the occurrence of corresponding complications, which is worthy of clinical promotion. doi:10.3969/j.issn.1672⁃6731.2021.04.015

Keywords

• pituitary neoplasms
• adenoma
• cerebrospinal fluid leak
• sella turcica
• dura mater
• suture techniques
• neuroendoscopy
• neurosurgical procedures