Clinical trial · Interventional
Application Research on Endoscopic Pseudocapsule-Based Resection for Pituitary Adenomas
Department of Neurosurgery, Affiliated Hospital of Nantong University
- Source
- ClinicalTrials.gov
- Retrieved
- Sep 8, 2026
- Layer
- normalized (units and labels harmonized; values unchanged)
- Run
- ING-CLINICALTRIALS-20260908-000001
Summary
Brief summary (as posted)
Pituitary adenomas are one of the most common primary central nervous system tumors and have an estimated prevalence of 17%. Management of pituitary adenomas involves a multidisciplinary approach that can incorporate surgical, medical, and/or radiation therapies. Over the last two decades, the endoscopic endonasal approach (EEA) has been extensively developed and refined for the resection of pituitary adenomas (PAs). In recent years, extracapsular resection (ER), which emphasized the importance of the pseudocapsule between the adenoma and surrounding normal gland tissue as a surgical plane, was adopted for more radical resection of the tumor. Therefore, dedicated high-resolution magnetic resonance imaging (MRI) protocols have been proposed to detect pituitary adenoma and accurately guide surgical removal. The evaluation of preoperative imaging for pseudocapsule is very important to the surgical method. Depending on different tumor sizes and pseudocapsule development, investigators adopted different resection strategies. To accomplish complete PA removal and minimize the impact on pituitary functions, intraoperative navigation was used to identify the tumor pseudocapsule, also the suspicious tissue was sent to the pathology department for histopathology intraoperatively. Long-term postoperative follow-up imaging and endocrine data were used to evaluate tumor prognosis. Standardized management and established biobank is critical for pituitary adenomas.
Conditions
Conditions (1)
Free-text conditions as registered, with the CancerIndex entity they were reconciled to and the match type.
| Condition (as posted) | Mapped entity | Match | Confidence |
|---|---|---|---|
| Pituitary Adenoma | Pituitary Neuroendocrine Tumor | ALIAS | 0.90 |
Interventions
Interventions (1)
| Intervention | Type | Mapped drug | Match |
|---|---|---|---|
| Excision of pituitary tumor outside pseudocapsule | Procedure | — | UNRESOLVED |
Design
Arms and outcomes
Arms (1)
- type
- EXPERIMENTAL
- label
- Intracapsular excision of pituitary tumor
- description
- Literature review was conducted to calculate the excision rate, postoperative recurrence rate and postoperative endocrine improvement of previous endoscopic intracapsular excision of pituitary tumor.
- interventionNames
- Procedure: Excision of pituitary tumor outside pseudocapsule
Primary outcomes (2)
- measure
- Tumor recurrence
- timeFrame
- Change from baseline (before operation), within 3 days, 3 months, 6 months, 1 year and 2 years after surgery
- description
- All patients undergo high-resolution magnetic resonance imaging (MRI) examination before operation, within 3 days, 3 months, 6 months, and twice per year after surgery. The degree of resection was calculated by measuring the residual tumor volume using MRI data. Comparing preoperative and postoperative tumor imaging changes, investigators will assess the helpfulness of preoperative imaging judgments for intraoperative tumor resection, and compare the efficacy of different surgical modalities.
Eligibility
Eligibility (as posted)
- Sex
- All
- Minimum age
- 18 Years
- Maximum age
- 75 Years
Show eligibility criteria text
Inclusion criteria: According to guidelines for treatment of pituitary tumors，Patients can be eligible for surgery. Exclusion criteria: 1. Patients with other primary endocrine diseases. 2. Patients with obviously suprasellar and parasellar extensions or with cavernous sinus invasion (grade 4 of knosp classification ). 3. Patients with recent nasal trauma. 4. Patients with nasal infection or/and sphenoid sinus inflammation. 5. Patients with with abnormal coagulation. 6. Patients with other serious diseases.
References
Publications (9)
- RESULTCushing H. III. Partial Hypophysectomy for Acromegaly: With Remarks on the Function of the Hypophysis. Ann Surg. 1909 Dec;50(6):1002-17. doi: 10.1097/00000658-190912000-00003. No abstract available. PMID 17862444
- RESULTJankowski R, Auque J, Simon C, Marchal JC, Hepner H, Wayoff M. Endoscopic pituitary tumor surgery. Laryngoscope. 1992 Feb;102(2):198-202. doi: 10.1288/00005537-199202000-00016. No abstract available. PMID 1738293
- RESULTHardy J. Transsphenoidal hypophysectomy. 1971. J Neurosurg. 2007 Aug;107(2):458-71. doi: 10.3171/JNS-07/08/0458. No abstract available. PMID 17695407
- RESULTCostello RT. Subclinical Adenoma of the Pituitary Gland. Am J Pathol. 1936 Mar;12(2):205-216.1. No abstract available. PMID 19970261
- RESULTOldfield EH, Vortmeyer AO. Development of a histological pseudocapsule and its use as a surgical capsule in the excision of pituitary tumors. J Neurosurg. 2006 Jan;104(1):7-19. doi: 10.3171/jns.2006.104.1.7. PMID 16509142
- RESULTLee EJ, Ahn JY, Noh T, Kim SH, Kim TS, Kim SH. Tumor tissue identification in the pseudocapsule of pituitary adenoma: should the pseudocapsule be removed for total resection of pituitary adenoma? Neurosurgery. 2009 Mar;64(3 Suppl):ons62-9; discussion ons69-70. doi: 10.1227/01.NEU.0000330406.73157.49. PMID 19240574
- RESULTTaylor DG, Jane JA, Oldfield EH. Resection of pituitary macroadenomas via the pseudocapsule along the posterior tumor margin: a cohort study and technical note. J Neurosurg. 2018 Feb;128(2):422-428. doi: 10.3171/2017.7.JNS171658. Epub 2017 Aug 18. PMID 28820308
- RESULTNagata Y, Takeuchi K, Yamamoto T, Ishikawa T, Kawabata T, Shimoyama Y, Inoshita N, Wakabayashi T. Peel-off resection of the pituitary gland for functional pituitary adenomas: pathological significance and impact on pituitary function. Pituitary. 2019 Oct;22(5):507-513. doi: 10.1007/s11102-019-00980-w.