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Microscopic pituitary surgery

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https://www.readbyqxmd.com/read/29581739/investigating-the-application-of-diving-endoscopic-technique-in-determining-the-extent-of-pituitary-adenoma-resection-via-the-trans-nasal-sphenoidal-approach
#1
Hai-Bin Gao, Li-Qing Wang, Jian-Yun Zhou, Wei Sun
The aim of the present study was to investigate the advantages and disadvantages of the diving endoscopic technique in pituitary adenoma surgery, and the application value in determining the extent of tumor resection. A total of 37 patients with pituitary adenoma initially underwent tumor resection under an endoscope-assisted microscope via standard trans-nasal-sphenoidal approach, and tumor cavity structure was observed by applying the diving endoscopic technique. Surgery was subsequently performed again under a microscope or endoscope...
April 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29554355/bilateral-adrenalectomy-in-congenital-adrenal-hyperplasia-a-systematic-review-and-meta-analysis
#2
Diana MacKay, Anna Nordenström, Henrik Falhammar
Context: Management of congenital adrenal hyperplasia (CAH) involves suppression of the hypothalamic-pituitary-adrenal (HPA) axis using supraphysiological doses of exogenous glucocorticoids. This can pose a challenge, with Cushing's syndrome being a frequent complication of adequate suppression. Bilateral adrenalectomy, with subsequent replacement of glucocorticoids and mineralocorticoids at physiological doses, has been proposed as an alternative therapeutic strategy. Objective: To review the outcomes following bilateral adrenalectomy for CAH...
March 15, 2018: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29515939/evolution-of-technique-in-endoscopic-transsphenoidal-surgery-for-pituitary-adenoma-a-single-institution-experience-from-220-procedures
#3
Ake Hansasuta, Siriwut Pokanan, Pritsana Punyawai, Wattana Mahattanakul
Introduction Endoscopic transsphenoidal surgery (ETSS) for pituitary adenoma (PA) has been a recent shift from the traditional microscopic technique. Although some literature demonstrated superiority of ETSS over the microscopic method and some evaluated mono- vs. binostril access within the ETSS, none had explored the potential influence of dedicated instrument, as this procedure had evolved, on patients' outcomes when compared to traditional microscopic tools. Objective To investigate our own clinical and radiographic outcomes of ETSS for PA with its technical evolution over time as well as a significance of, having vs...
January 1, 2018: Curēus
https://www.readbyqxmd.com/read/29417847/clinical-outcomes-of-endoscopic-versus-microscopic-trans-sphenoidal-surgery-for-large-pituitary-adenoma
#4
Hamideh Akbari, Mojtaba Malek, Mohammad Ghorbani, Seyed Mahmoud Ramak Hashemi, Mohammad Ebrahim Khamseh, Ali Zare Mehrjardi, Zahra Emami, Ameneh Ebrahim Valojerdi
OBJECTIVE: To compare clinical outcomes of large pituitary adenomas (≥3 cm in maximum diameter), operated on by Endoscopic Transsphenoidal Surgery (ETS), versus Microscopic Transsphenoidal Surgery (MTS). METHODS: Medical records and MRI Scans of patients with a diagnosis of pituitary adenoma for whom transphenoidal surgery was done were reviewed. Complete pre and post-operative data were available for 121 patients. Thirty five patients had large pituitary adenoma and were enrolled in this study...
February 8, 2018: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29314715/outcomes-of-endoscopic-and-microscopic-transsphenoidal-surgery-on-non-functioning-pituitary-adenomas-a-systematic-review-and-meta-analysis
#5
Shi-Yuan Yu, Qiu Du, Si-Yuan Yao, Ke-Nan Zhang, Jian Wang, Zhe Zhu, Xiao-Bing Jiang
Both microscopic and endoscopic transsphenoidal surgery are effective approaches for nonfunctioning pituitary adenomas. The issue on the comparison of their efficacy and safety remains inconsistent. A thorough search of the literatures (PubMed, EMBASE, MEDLINE) were performed up to March 2017. Studies reporting outcomes of microscopic or endoscopic transsphenoidal surgery on nonfunctioning pituitary adenomas were included. A meta-analysis was performed focusing on the early stage and long term outcomes. The final search yielded 19 eligible studies enrolling 3847 patients, 389 of them underwent microscopic approach and 3458 of them with endoscopic approach...
March 2018: Journal of Cellular and Molecular Medicine
https://www.readbyqxmd.com/read/29307020/gross-total-resection-of-pituitary-adenomas-after-endoscopic-vs-microscopic-transsphenoidal-surgery-a-meta-analysis
#6
REVIEW
Reem D Almutairi, Ivo S Muskens, David J Cote, Mark D Dijkman, Vasileios K Kavouridis, Erin Crocker, Kholoud Ghazawi, Marike L D Broekman, Timothy R Smith, Rania A Mekary, Hasan A Zaidi
BACKGROUND: Microscopic transsphenoidal surgery (mTSS) is a well-established method to address adenomas of the pituitary gland. Endoscopic transsphenoidal surgery (eTSS) has become a viable alternative, however. Advocates suggest that the greater illumination, panoramic visualization, and angled endoscopic views afforded by eTSS may allow for higher rates of gross total tumor resection (GTR). The aim of this meta-analysis was to determine the rate of GTR using mTSS and eTSS. METHODS: A meta-analysis of the literature was conducted using PubMed, EMBASE, and Cochrane databases through July 2017 in accordance with PRISMA guidelines...
January 6, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29288106/pituitary-apoplexy-should-endoscopic-surgery-be-the-gold-standard
#7
Joaquim Cruz Teixeira, José Lavrador, Diogo Simão, José Miguéns
BACKGROUND: Pituitary apoplexy is an uncommon, potentially fatal condition due to spontaneous ischemia or hemorrhage in a pituitary adenoma. The treatment of this disorder has long been a matter of debate. METHODS: Retrospective cohort study including all patients admitted with pituitary apoplexy in our department between 2005 and 2015 was undertaken. Clinical symptoms and signs on admission, treatment (conservative vs. surgical), neurologic deficit on discharge and at 6 months' follow-up, and endocrinologic evaluation at 6 months' follow-up were analyzed...
March 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29280026/management-of-non-functioning-pituitary-adenomas-surgery
#8
REVIEW
David L Penn, William T Burke, Edward R Laws
Non-functional pituitary adenomas (NFPAs) are benign tumors of the pituitary gland that do not over-secrete hormonal products, therefore, they are generally detected through symptoms of mass effect, including headache, vision loss, or hypopituitarism. There are multiple pathological subtypes of NFPAs, such as null cell adenomas, silent gonadotrophs, silent somatotrophs, silent corticotrophs, and silent subtype 3, all of which can be classified based on immunohistochemical studies and electron microscopy. Despite these numerous pathological subtypes, surgical resection remains the first-line treatment for NFPAs...
April 2018: Pituitary
https://www.readbyqxmd.com/read/29194269/bibliometric-analysis-of-journals-in-the-field-of-endoscopic-endonasal-surgery-for-pituitary-adenomas
#9
Lei Li, Xiaoye Ma, Sajan Pandey, Aoyuan Fan, Xianyu Deng, Daming Cui
Endoscopic endonasal surgery for pituitary adenomas is being performed more frequently worldwide in the recent years. This first bibliometric analysis was conducted aiming to have a microscopic view of research activities about endoscopic endonasal surgery for pituitary adenomas. The original articles about endoscopic endonasal surgery for pituitary adenomas were extracted from the Web of Science (WoS) and analyzed concerning their distributions. We also explored the potential correlations between publications of different countries and their gross domestic product (GDP) via Pearson correlation test...
January 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29171583/comparison-between-endoscopic-and-microscopic-approaches-for-surgery-of-pituitary-tumours
#10
Inamullah Khan, Muhammad Shahzad Shamim
Surgical techniques for resection of pituitary tumours have come a long way since it was first introduced in late 18th century. Nowadays, most pituitary surgeries are performed through trans-nasal trans-sphenoidal approach either using a microscope, or an endoscope. Herein the authors review the literature and compare these two instruments with regards to their outcomes when used for resection of pituitary tumours. .
November 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/29158096/cost-effectiveness-of-endoscopic-versus-microscopic-transsphenoidal-surgery-for-pituitary-adenoma
#11
Jared D Ament, Zhuo Yang, Vic Khatchadourian, Edward B Strong, Kiarash Shahlaie
BACKGROUND: Endoscopic transsphenoidal surgery (ETPS) has become increasingly popular for resection of pituitary tumors, whereas microscopic transsphenoidal surgery (MTPS) also remains a commonly used approach. The economic sustainability of new techniques and technologies is rarely evaluated in the neurosurgical skull base literature. The aim of this study was to determine the cost-effectiveness of ETPS compared with MTPS. METHODS: A Markov model was constructed to conduct a cost-utility analysis of ETPS versus MTPS from a single-payer health care perspective...
February 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29080355/tumour-lateralization-in-cushing-s-disease-by-inferior-petrosal-sinus-sampling-with-desmopressin
#12
Ming Feng, Ziyuan Liu, Xiaohai Liu, Xiaobo Zhang, Xinjie Bao, Yong Yao, Kan Deng, Bing Xing, Wei Lian, Huijuan Zhu, Lin Lu, Renzhi Wang
BACKGROUND: Bilateral inferior petrosal sinus sampling (IPSS) with corticotropin-releasing hormone (CRH) is currently the gold standard in the diagnosis of Cushing's disease (CD) and has also been used in tumour lateralization. Our objective was to determine the diagnostic value and lateralization accuracy of IPSS with desmopressin. METHODS: We retrospectively analysed 91 patients with Cushing's syndrome who had either negative findings on pituitary dynamic enhanced magnetic resonance imaging (MRI) or nonsuppressed high-dose dexamethasone suppression tests (HDDST)...
February 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29045853/symptomatic-vasospasms-as-a-life-threatening-complication-after-transsphenoidal-surgery
#13
Katharina Osterhage, Patrick Czorlich, Till R Burkhardt, Roman Rotermund, Ulrich Grzyska, Jörg Flitsch
OBJECTIVE: To identify symptomatic vasospasms as a rare complication after pituitary surgery with emphasis on management and outcome. DESIGN AND METHODS: In a retrospective design, 1997 patient charts undergoing microscopic transsphenoidal surgery from 2008 till 2016 were retrospectively analyzed regarding postoperative vasospastic events, its' clinical management, and neurological outcome. RESULTS: Four patients (0.2%) were identified, who developed neurological deficits in the postoperative phase caused by proven vasospasms due to subarachnoid hemorrhage (SAH)...
October 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29040677/navigation-linked-heads-up-display-in-intracranial-surgery-early-experience
#14
Justin R Mascitelli, Leslie Schlachter, Alexander G Chartrain, Holly Oemke, Jeffrey Gilligan, Anthony B Costa, Raj K Shrivastava, Joshua B Bederson
BACKGROUND: The use of intraoperative navigation during microscope cases can be limited when attention needs to be divided between the operative field and the navigation screens. Heads-up display (HUD), also referred to as augmented reality, permits visualization of navigation information during surgery workflow. OBJECTIVE: To detail our initial experience with HUD. METHODS: We retrospectively reviewed patients who underwent HUD-assisted surgery from April 2016 through April 2017...
October 10, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29017983/endoscopic-transsphenoidal-surgery-outcomes-in-331-nonfunctioning-pituitary-adenoma-cases-after-a-single-surgeon-learning-curve
#15
Jung Hee Kim, Jung Hyun Lee, Ji Hyun Lee, A Ram Hong, Yoon Ji Kim, Yong Hwy Kim
OBJECTIVE: The outcomes of recent endoscopic surgery of nonfunctioning pituitary adenomas (NFPAs) are controversial when compared with traditional microscopic surgery. We aimed to assess the outcomes of endoscopic transsphenoidal surgeries performed by 1 surgeon with 7 years of experience and elucidate the predictive factors for surgical outcomes for NFPAs. METHODS: We included 331 patients (155 men and 176 women) with clinical NFPAs who underwent transsphenoidal surgery because of visual symptoms by a single surgeon in Seoul National University Hospital from March 2010 to May 2016...
January 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29016590/endoscopic-endonasal-transsphenoidal-approach-to-pituitary-adenoma-a-multi-disciplinary-approach
#16
Deepak Regmi, Amit Thapa, Bidur Kc, Bikram Shakya
BACKGROUND: The excellent visualization and minimally invasive approach employed in endoscopic endonasal procedures has now revolutionized the pituitary surgery, replacing the transnasal microscopic technique worldwide. However, it involves major shift in hand-eye co-ordination from static 3 dimensional images of microscope to 2 dimensional endoscopic images hence demands training and inter-disciplinary approach. Here we present our experiences in learning and developing a safe endonasal transsphenoidal endoscopic approach to resect pituitary adenomas...
September 8, 2017: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/28988650/learning-curve-of-endoscopic-pituitary-surgery-experience-of-a-neurosurgery-ent-collaboration
#17
Giorgio Lofrese, Vera Vigo, Mario Rigante, Domenico Luca Grieco, Maddalena Maresca, Carmelo Anile, Annunziato Mangiola, Pasquale De Bonis
For neurosurgeons, who are accustomed to the binocular microscope, there is a new learning curve that must be overcome for monocular endoscopic pituitary surgery. Different studies describe a learning curve between 15 and 200 procedures, after which both operative time and complications stabilize. In this retrospective study, we evaluate the endoscopic learning curve of our group, already trained in microsurgical transsphenoidal surgery, with the assistance of ear, nose, and throat (ENT) surgeons. From 2010 to 2015, a total of 95 patients with pituitary adenomas were treated with a purely endoscopic approach...
January 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28967314/endoscopic-endonasal-pituitary-gland-hemi-transposition-for-resection-of-a-dorsum-sellae-meningioma
#18
Alaa S Montaser, Juan M Revuelta Barbero, Alexandre Todeschini, André Beer-Furlan, Russell R Lonser, Ricardo L Carrau, Daniel M Prevedello
A 69-year-old female with incidental diagnosis of a dorsum sellae meningioma had shown significant tumor growth after initial conservative management. The procedure started with a microscopic sublabial transsphenoidal approach to the sella and the suprasellar space. Due to limitations to a safe dissection and removal of the retrosellar component, the surgery was converted to a purely endoscopic endonasal approach with left hemi-transposition of the pituitary gland, followed by drilling of the dorsum sellae and removal of the left posterior clinoid process...
October 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28960156/identification-and-repair-of-intraoperative-cerebrospinal-fluid-leaks-in-endonasal-transsphenoidal-pituitary-surgery-surgical-experience-in-a-series-of-1002-patients
#19
Ben A Strickland, Joshua Lucas, Brianna Harris, Edwin Kulubya, Joshua Bakhsheshian, Charles Liu, Bozena Wrobel, John D Carmichael, Martin Weiss, Gabriel Zada
OBJECTIVE Cerebrospinal fluid (CSF) rhinorrhea is among the most common complications following transsphenoidal surgery for sellar region lesions. The aim of this study was to review the authors' institutional experience in identifying, repairing, and treating CSF leaks associated with direct endonasal transsphenoidal operations. METHODS The authors performed a retrospective review of cases involving surgical treatment of pituitary adenomas and other sellar lesions at the University of Southern California between December 1995 and March 2016...
September 29, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28919622/incidence-of-diabetes-insipidus-in-postoperative-period-among-the-patients-undergoing-pituitary-tumour-surgery
#20
M L Kadir, M T Islam, M M Hossain, S Sultana, R Nasrin, M M Hossain
Post operative complications after pituitary tumour surgery vary according to procedure. There are several surgical procedures being done such as transcranial, transsphenoidal microsurgical and transsphenoidal endoscopic approaches. One of the commonest complications is diabetes insipidus (DI). Our main objective was to find out the incidence of diabetes insipidus in post operative period among patients undergoing surgical intervention for pituitary tumour in our institute. The presence of diabetes insipidus in the postoperative period was established by measuring serum Na+ concentration, hourly urine output and urinary specific gravity to find out the incidence of diabetes insipidus in postoperative period in relation to age, gender, tumour diameter, function of tumour (i...
July 2017: Mymensingh Medical Journal: MMJ
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