Two-stage surgical treatment of giant pituitary adenomas

Abstract

Introduction. Surgical treatment of invasive giant pituitary adenomas (GPA) with sub- and intracranial growth is a complex problem due to a high risk of their one-stage removing. Own experience of two-stage surgical treatment of patients with GPA, needed combined surgical approaches was generalized.Materials and methods. 9 cases of two-stage surgical treatment of patients with GPA are given. Patients’ average age was 41.3 years, there were 5 women and 4 men. 18 operations with surgical approaches combination were performed: 10 — using transsphenoidal, and 8 — transcranial approach.Results. None of the tumor was removed radically, subtotal resection (70–90% of the tumor) was performed in 5 cases; almost full resection (more than 90%) — in 4, all patients were alive. Complications and their course in early postoperative period were described.Conclusions. Two-stage surgical treatment of patients with GPA is effective and provides long-term clinical results. Combination of transcranial and transsphenoidal approaches for GPA removing permits to use advantages of both.