Abstract
Introduction: knowledge of anatomical structures of the human body, great technical abilities, and understanding of the pathophysiology of the pituitary gland. Therefore, it must not be considered a simple surgical procedure, but rather the outcome of work that is done among several specialists including endocrinology, neurosurgery, neuroradiology, pathology, ophthalmology, along with other specialties. In this healthy cooperating environment every member will play a distinct part, providing his/her contribution to the final outcome, which specifically affects a single patient. Now, It is possible to treat several different pituitary gland conditions with more than a single option, including medical treatment, surgical treatment, and radiotherapeutic treatment possible modalities, alone or in combinations. Surgery to the Pituitary gland, maybe more than other areas of surgery, needs strict postoperative care and long-term follow-up of patients; applying these measures will create the differences between a patient with satisfactory outcomes and a patient with poor outcomes. The patient might have a successful surgical operation, but the results might not be as good as the surgeon promised if there is absence of mutual exchange between team members or if the work is not implemented right with having every member contributing to the outcomes of the patient. It is in this environment that surgery of the pituitary gland must be present currently, with the neurosurgeons working with the techniques, the indications, and the outcomes is playing a refined role as a part of an expert team: they must have detailed knowledge of anatomy, have sufficient experience neuroimaging, have knowledge in the pathophysiology and the history of pituitary gland diseases, and have sufficient knowledge of all the therapeutic modalities. Therefore, The neurosurgeon has an essential role in these procedures, completely informed of current therapeutic modalities in the patient's interests and of the institution where the surgery is being operated. In this review, we will discuss the most recent evidence regarding Surgical approach to pituitary tumors
Aim of work: In this review, we will discuss Surgical approach to pituitary tumors
Methodology: We did a systematic search for Surgical approach to pituitary tumors using PubMed search engine (http://www.ncbi.nlm.nih.gov/) and Google Scholar search engine (https://scholar.google.com). All relevant studies were retrieved and discussed. We only included full articles. The terms used in the search were: Surgical approach, pituitary tumors, management, presentation.
Conclusions: Surgical interventions, either through the transsphenoidal or the transcranial approach, must achieve complete resection of the lesion during the first surgery, if possible, for the patient's best chance of "cure". Only minimal risk can be borne by the patient in terms of morbidity and mortality; the surgeon should always try a total and radical outcome, but at the same time must also keep in mind that several different options - including medical, surgical, and/or radiotherapeutic - are now proven effective for the treatment in terms of long-term outcomes. What is crucial, regardless of the surgical option selected for a single case, whether transsphenoidal or transcranial, is to relate the goal of surgery to the patient's needs, selecting the best option for the actual condition of the patient from among all the options available, surgical or otherwise.