OBJECT: The purpose of this study was to analyze preoperative predictors of endocrinological remission following endonasal endoscopic resection of therapy-resistant prolactin-, @entity2124 ( @entity2124 )-, and @entity4545 (ACTH)-secreting @entity977 and to establish benchmarks for cure by using the most recent consensus criteria. METHODS: The authors reviewed a prospective database of 86 consecutive functional @entity977 that were resected by a purely endoscopic endonasal transsphenoidal technique. Extent of resection was evaluated on postoperative contrast-enhanced MR imaging. Endocrinological remission was defined according to the most recent consensus criteria. RESULTS: The majority of functional @entity652 (62.8%) were classified as macroadenomas (> 1 cm in maximum diameter), and 20.9% of lesions had invaded the cavernous sinus (CS) at the time of surgery. A gross-total resection was achieved in 75.6% of all @entity1 . The rate of endocrinological remission differed between various types of functional @entity652 . Cure rates were 92.3% (microadenomas) and 57.1% (macroadenomas) for @entity2013 , 75% (microadenomas) and 40% (macroadenomas) for @entity2124 -secreting @entity5 , and 54.5% (microadenomas) and 71.4% (macroadenomas) for ACTH-secreting @entity5 . Lower rates of cure occurred in @entity2124 -secreting macroadenomas due to a high rate of CS invasion, and in ACTH-secreting @entity652 due to a high rate of lesions that were not visible on preoperative MR imaging. Whereas univariate analysis showed that macroadenoma, suprasellar, cavernous extension, or extent of resection correlated with cure, on multivariate analysis, only extent of resection and suprasellar extension predicted cure. One @entity1 developed @entity86 that was complicated by @entity1276 requiring a ventriculoperitoneal shunt. Two @entity1 developed @entity86 , and 2 @entity1 suffered from CSF leaks, which were treated with lumbar CSF diversion. CONCLUSIONS: This paper reports benchmarks for endocrinological cure as well as complications in a large series of purely endoscopic pituitary surgeries by using the most recent consensus criteria. The advantages of extended endonasal approaches are most profound in @entity5 with suprasellar extension and CS invasion.

Endoscopic endonasal transsphenoidal surgery for functional XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity4545 :: ('5443', 'Gene') :: ['adrenocorticotropic hormone'] @entity2013 :: ('MESH:D015175', 'Disease') :: ['prolactinomas'] @entity1276 :: ('MESH:D006849', 'Disease') :: ['hydrocephalus'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumors'] @entity2124 :: ('2688', 'Gene') :: ['GH', 'growth hormone'] @entity977 :: ('MESH:D010911', 'Disease') :: ['pituitary adenomas'] @entity86 :: ('MESH:D019106', 'Disease') :: ['postoperative panhypopituitarism', 'postoperative meningitis'] @entity652 :: ('MESH:D000236', 'Disease') :: ['adenomas']
@entity977 :: (MESH:D010911,Disease) :: ['pituitary adenomas']
