gms | German Medical Science

Objective: The benefit of modern minimally invasive surgical treatment for sellar lesions is under debate. Thus, we performed a study of our patients over the last 40 years.

Method: A retrospective statistical analysis was performed for 278 patients with sellar lesions who underwent surgery at the Neurosurgical Department of the Saarland University between 1963 - 1980 (group A), 1990 - 2000 (group B), 2011- 2014 (group C). Mean follow-up time period was 17yrs (range 0.5 - 44.5 yrs).

Results: Each group consisted of pituitary adenomas, craniopharyngeomas and rathke's cleft cysts equally. Tumor size is significant lower at diagnosis nowadays. In group A 45% of procedures were performed using transcranial approaches, in group B 9.5% and in group C 1%. Radicality could be significantly increased from 68% to 86% from group A to group C. On the other hand, the number of perioperative complications were significantly reduced from 27% (group A) to 16% (group B) to 5% (group C). Breaking down the postoperative mortality by the described groups the mortality decreased from 16% to 0%. Recurrence free survival could be increased for patients operated after 2011 significantly (p<0.01).

Conclusions: Based on the results of this study, the overall prognosis and also the surgical morbidity and mortality for patients with sellar lesions has changed from the 1960s until today significantly. Thus, the introduction of modern diagnostic modalities and new neurosurgical procedures has improved the outcome and safety in these patients.