Repeat transsphenoidal surgery for pituitary adenoma

Objective To explore the strategies of repeat transsphenoidal surgery (TSS) for pituitary adenomas.Methods Surgical techniques and treatment outcomes of 23 patients with pituitary adenomas,performed repeat TSS in our hospital from January 2003 to October 2012,were retrospectively analyzed.Results All repeat TSS were done under a microscope; four patients were performed navigation-guided surgery and one patient used C-arm fluoroscopy.The tumor heights were 15-45 mm,and the tumors were total removed in 12 cases,subtotal resection or most resection in 10 cases and partial removal in 1 case.There were 10 cases of cerebrospinal fluid leakage during operation.Eighteen cases were followed up,with postoperative abducens nerve palsy and long-term diabetes insipidus in one each case,and one case needed the hormone replacement therapy.Conclusion Repeat TSS should correct surgical approach as much as possible and enlarge the tumor' s exposure,and should be alert to the occurrence of cerebrospinal fluid leakage. Key words: Pituitary adenoma;  Recurrence;  Residual;  Repeat transsphenoidal surgery