gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

Transsphenoidal surgery for pituitary adenoma and craniopharyngioma with endoscope assistance, special emphasis on tips and how to avoid complications

Meeting Abstract

  • K. Kurisu - Department of Neurosurgery, Hiroshima University Hospital, Hiroshima, Japan
  • A. Tominaga - Department of Neurosurgery, Hiroshima University Hospital, Hiroshima, Japan
  • Y. Kinoshita - Department of Neurosurgery, Hiroshima University Hospital, Hiroshima, Japan
  • S. Usui - Department of Neurosurgery, Hiroshima University Hospital, Hiroshima, Japan
  • T. Sakoguchi - Department of Neurosurgery, Hiroshima University Hospital, Hiroshima, Japan
  • K. Sugiyama - Department of Neurosurgery, Hiroshima University Hospital, Hiroshima, Japan

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocMI.03.03

DOI: 10.3205/12dgnc007, URN: urn:nbn:de:0183-12dgnc0077

Published: June 4, 2012

© 2012 Kurisu et al.
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Outline

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Objective: We have no objection to the doctrine that micro-neurosurgery under the operating microscope is crucial to the basis of neurosurgery. But in recent years, endoscopic micro-neurosurgery has been spreading dramatically and very speedily. We have also steadily expanded the indication for the endoscopic approach with the microscope in a safe and accurate fashion. We compared the normalization rate of growth hormone and IGF-1 between the microscope era (1995–1999, n = 32) and the era of combined use (2000–2010, n = 93).

Methods: We analyzed the nadir value of GH with OGTT and IGF-1 before and after TSS between both eras in acromegaly patients from 1995 to 1999, who underwent microscopic surgery and from 2000 to 2010 who underwent combined use surgery.

Results: The cure rate using the Knosp grade 0 to 2 was 83% in the microscope era and 92% in the combined use era, respectively. The cure rate using Knosp grade 3 to 4 was 13% and 24%, respectively. In all periods, it was 66% and 76%, respectively. According to IGF-1 normalization, in total, it was 56% and 67%, respectively. In this presentation, we will show our present status of microscopic and endoscopic removal of pituitary adenoma and craniopharyngioma via the transnasal route. We would also like to emphasize the benefit of combined use, tips and tactics and how to avoid complications using this approach.

Conclusions: In conclusion, the combined use of microscope and endoscope provide good surgical results with a higher cure rate of pituitary adenoma and craniopharyngioma.