International Journal of Radiation Research

en Adoption of adjustable pressure endoscopic diving technique in pituitary tumor resection after radiotherapy Radiation Biology Radiation Biology تحقيق بديع Original Research <div style="text-align: justify;">Background: Endoscopic endonasal transsphenoidal pituitary adenoma resection faces challenges like bleeding and tissue folds that can reduce visual clarity, particularly in patients with prior radiotherapy, where altered tissue characteristics complicate the procedure. The adjustable-pressure endoscopic diving technique may help address these challenges by enhancing visualization through fluid medium regulation. The aim of this study is to assess the efficacy and safety of the adjustable-pressure endoscopic diving technique in pituitary tumor resection after radiotherapy. Materials and Methods: This retrospective multi-center study included 63 patients who underwent endoscopic endonasal tumor resection. The cohort consisted of patients with sellar and parasellar tumors, including pituitary adenomas, some of whom had previously received radiotherapy. Radiotherapy modalities included conventional fractionated external beam radiotherapy (EBRT) and/or stereotactic radiosurgery (SRS), depending on prior treatment history. During surgery, an adjustable-pressure saline irrigation system was used to fill the resection cavity, allowing enhanced visualization and detection of residual tumor tissue. Results: The diving technique was successfully implemented in 61 of 63 cases (96.8%). Following standard tumor debulking, intraoperative saline immersion allowed identification of residual tumor tissue in 53 of these cases (86.9%), primarily within recessed or irregular cavity surfaces. Tumor size was an independent predictor of intraoperative tumor residue (OR=5.15, P=0.010), and subtotal resection was linked to higher recurrence risk (OR=11.22, P=0.025). Complications included transient diabetes insipidus (22.2%) and cerebrospinal fluid leakage (14.3%). Conclusion: The adjustable-pressure endoscopic diving technique effectively identifies residual tumors, particularly in post-radiotherapy cases, and offers a favorable safety profile. It holds promise for wider clinical use.</div> Pituitary adenoma, neuroendoscopy, diving technique, adjustable pressure, radiotherapy, tumor resection. 1115 1122 http://ijrr.com/browse.php?a_code=A-10-1-1623&slc_lang=en&sid=1 H. Zhong 7900319475328460035054 7900319475328460035054 No Department of Neurosurgery, First Affiliated Hospital of Xi'an Medical University, School of General Medicine, Xi'an Medical University, Xi'an, Shaanxi Province, China Z.B. Ding 7900319475328460035055 7900319475328460035055 No Department of Neurosurgery, First Affiliated Hospital of Xi'an Medical University, School of General Medicine, Xi'an Medical University, Xi'an, Shaanxi Province, China W.J. Xing 7900319475328460035056 7900319475328460035056 No Department of Neurosurgery, First Affiliated Hospital of Xi'an Medical University, School of General Medicine, Xi'an Medical University, Xi'an, Shaanxi Province, China J.F. Zhang 7900319475328460035057 7900319475328460035057 No Department of Neurosurgery, First Affiliated Hospital of Xi'an Medical University, School of General Medicine, Xi'an Medical University, Xi'an, Shaanxi Province, China G.F. Sun 7900319475328460035058 7900319475328460035058 No Brain Hospital, Xi'an People's Hospital (Xi'an Fourth Hospital), Xi'an, Shaanxi Province, China W.P. Liu xyyfy1986@163.com 7900319475328460035059 7900319475328460035059 Yes Department of Neurosurgery, First Affiliated Hospital of Xi'an Medical University, School of General Medicine, Xi'an Medical University, Xi'an, Shaanxi Province, China