• World Neurosurg · Sep 2016

    The surgical side effects of pseudocapsular resection in non-functioning pituitary adenomas.

    • Yasuyuki Kinoshita, Atsushi Tominaga, Satoshi Usui, Kazunori Arita, Tetsuhiko Sakoguchi, Kazuhiko Sugiyama, and Kaoru Kurisu.
    • Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan. Electronic address: y-kinoshita@hiroshima-u.ac.jp.
    • World Neurosurg. 2016 Sep 1; 93: 430-435.e1.

    ObjectivePseudocapsular resection is a useful surgical technique for removing functioning pituitary adenomas; however, the significance of this procedure in nonfunctioning pituitary adenomas (NFPAs) had not been discussed in detail. We clarify the safety of pseudocapsular resection in NFPAs based on the incidence of surgical complications and evaluation of pituitary function.MethodsIn 143 patients, initial surgery for NFPAs was performed with preoperative and postoperative pituitary provocation tests. Patients were categorized into 3 groups: total group (n = 65), in which the pseudocapsule was totally removed; partial group (n = 11), in which the pseudocapsule was partially removed; and nonremoval group (n = 67), in which the pseudocapsule was not removed or did not exist. The main outcome measure was the incidence of surgical complications and postoperative pituitary functions.ResultsIntraoperative cerebrospinal fluid leakage and temporary diabetes insipidus occurred more frequently in the total group than in the nonremoval group; however, the differences were not statistically significant. There was no difference in the incidence of any other complications, including postoperative cerebrospinal fluid leakage and permanent diabetes insipidus, between the total and nonremoval groups. Postoperative anterior pituitary function improved to the same degree in both the total and the nonremoval groups. Univariate and multivariate analyses revealed that pseudocapsular resection was not a factor in the postoperative deterioration of pituitary function.ConclusionsPseudocapsular resection in NFPAs does not increase the risk of surgical complications or aggravate postoperative pituitary function.Copyright © 2016 Elsevier Inc. All rights reserved.

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