Experience Of The Neurosurgery Department Of The Centre Hospitalier Initiative Plus (CHIP) And HJ Hospitals About 12 Cases In DRC (Democratic Republic Of Congo)

Abstract

Introduction: Pituitary tumors are common, dominated by pituitary adenomas with a prevalence ranging from 0.02 to 0.05%. Pituitary tumors are grouped into secretory and non-secretory tumors.  Surgery remains the preferred treatment for these tumors. Surgery of the base of the skull has undergone a major upheaval due to the introduction of endoscopic techniques which are part of minimally invasive surgery. The recent development of endoscopic surgery of the skull base, by endonasal, supraorbital and retrosigmoid routes, is part of the concept of minimally invasive neurosurgery. In this study, we will show the feasibility of endoscopic surgery in our country, evaluate and analyze the management in general. Material And Methods: This is a first experience of DRC in a retrospective study of 12 patients operated for pituitary adenomas confirmed on MRI and/or brain CT during a period from January 2020 to June 2022. We collected the data in two hospitals in the city of Kinshasa- DR Congo, CHIP and HJ Hospitals. This study consisted of an evaluation of the management and a clinical analysis of the series. Results: Of the 12 patients operated during the period of our study, the following parameters were analyzed: The average age was 50.5 years. The sex ratio (M/F) was 3/1. About 70% of the patients were hypertensive and/or diabetic. More than half of the patients had headaches and/or visual disturbances as a symptomatological revelation. All our patients had to undergo an imaging (MRI), hormonal and ophthalmological assessment. In the postoperative period, no deaths were recorded but one case of bleeding from the surgical site, i.e. 8.3%. The tumor resection was almost complete in 8 patients out of 12, i.e. 66.7%. Conclusion: Transphenoidal endonasal endoscopy represents currently in DRC a gold standard for the management of pituitary adenomas. Pituitary adenomas, despite their benign histologies, are characterized by a great evolutionary variety on the epidemiological, clinical, paraclinical, histological and postoperative levels. The endoscopic endonasal approach has improved morbidity and reduced hospitalization time. Patients should be referred as soon as possible for signs of intracranial hypertension.