Psuedo-Capsule Based Extracapsular Resection of Pituitary Adenoma

Background: Pituitary adenomas are the most common tumor in the sellar region. Different excision techniques were described to facilitate resection of tumors. The presence of pseudocapsule allows en bloc resection in this plane. Objective: The aim of this study is to assess the efficacy of extracapsular resection technique as regards the feasibility, value, extent of resection, biochemical remission and the incidence of postoperative complications. Patients and Methods: No special inclusion or exclusion criteria were used. The decision to use extra capsular technique was an intra operative one. All patients had MRI of the sella and CT of the paranasal sinuses before operation. Post operative assessment of the extent of resection was done by MRI on regular follow-up periods. Post operative hormonal assay was routinely done. Results: Twenty two patients were excised by this technique in the period between 2008 and 2014. Nine were hormone active and the other thirteen were non-functioning adenomas. Total resection was achieved in twenty one cases. Two cases had hypofunction and 27% had temporary Diabetes Insipidus (DI) postoperatively with no cases of permanent DI. Conclusion: extracapsular resection is a safe and effective technique in resection of pituitary adenomas especially in hormone active ones.