• Lei Mou, Jun Qin, Junrong Lei, Zhiming Chen, Jun Liu, and Chi Feng.
• Department of Neurological Surgery at Taihe Hospital, Hubei University of Medicine, Shiyan, China.
• World Neurosurg. 2024 Jun 17.

ObjectiveTo investigate the long-term clinical outcomes of staged surgical resection in giant Pituitary Neuroendocrine Tumors.MethodsWe performed a retrospective analysis of the clinical data of 16 patients who underwent surgery. The patients were diagnosed and underwent surgery at the Department of Neurosurgery of Shiyan Taihe Hospital from January 2013 to March 2021. Among the cases, 12 patients underwent primarily transsphenoidal surgery followed by secondary transcranial surgery, while 4 patients underwent primarily transsphenoidal surgery followed by secondary transsphenoidal surgery. Before the surgery, all patients underwent a pituitary magnetic resonance imaging (MRI) scan, pituitary hormone level examination, visual acuity, and visual field examination. A pituitary MRI was rechecked within 1 week after the operation. A tumor resection rate of 100% on MRI was considered as a total resection, between 90% and 100% as a subtotal resection, and lower than 90% as a partial resection. After the surgery, regular clinical visits and telephone or internet platform follow-ups were conducted.ResultsIn our clinical investigation, after staged surgery 10 patients had a total resection, 5 had a subtotal resection, and 1 had a partial resection depending on the tumor size and invasion. The clinical outcomes showed that 1 case suffered from postoperative intracranial infection, 1 case had decreased visual acuity, and 6 cases experienced decreased pituitary function after surgery.Postoperative complications were cured after symptomatic treatment, except for 1 patient who experienced decreased vision and 1 patient sufferred hypopituitarism required long-term oral levothyroxine tablet treatment. No cases of intracranial hemorrhage or death were caused by intentionally staged resection surgery.ConclusionsStaged surgery for giant Pituitary Neuroendocrine Tumors is a safe and effective clinical surgery strategy.Copyright © 2024 Elsevier Inc. All rights reserved.

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