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Microscopic pituitary surgery

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https://www.readbyqxmd.com/read/29868317/comparative-cost-analysis-of-endoscopic-versus-microscopic-endonasal-transsphenoidal-surgery-for-pituitary-adenomas
#1
Chikezie Ikechukwu Eseonu, Karim ReFaey, Oscar Garcia, Roberto Salvatori, Alfredo Quinones-Hinojosa
Objective  This study presents a comparative analysis of cost efficacy between the microscopic and endoscopic transsphenoidal approaches, evaluating neurological outcome, extent of resection (EOR), and inpatient hospital costs. Design  This study was a retrospective chart review. Setting  This study was conducted at a tertiary care center. Participants  The study group consisted of 68 patients with transsphenoidal surgeries between January 2007 and January 2014. Main Outcome Measures  Two-sample t -tests and Pearson's chi-square test evaluated inpatient costs, quality-adjusted life years (QALYs), volumetric EOR, and neurological outcomes...
April 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29852301/the-visualization-and-identification-of-the-pituitary-gland-tissue-in-endonasal-pituitary-surgery-is-there-a-difference-between-hd-endoscopy-and-microscopy
#2
Stefan Linsler, Nadja Szameitat, Sebastian Senger, Joachim Oertel
OBJECTIVE: Neurosurgical techniques for the treatment of sellar pathologies have been evolving continuously over the last decades. Additionally, to the innovation of approaches and surgical techniques, this progress yielded to the application of modern operative technologies. The introduction of high definition (HD) cameras for endoscopic systems has shown good results in endonasal pituitary surgery. The aim of this study was to assess endoscopic HD image quality in comparison to microscopic visualization...
May 28, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29798106/-analysis-of-olfactory-dysfunction-after-endoscopic-and-microscopic-endonasal-transsphenoidal-surgery-for-pituitary-adenoma
#3
X H Huo, L T Wang, Y Liang, Q Hou, J H Tian
Objective: To analyze the clinical data of patients with olfactory dysfunction after endoscopic or microscopic endonasal transsphenoidal approach,and to screen out the possible related factors,to guide clinical diagnosis and treatment,and to improve the patients' quality of life. Method: In the retrospective study,we analyze patients' data,and follow up them with telephone,records the olfactory levels before and after surgery. In the prospective study,five odors were applied to test the olfactory function before the surgery,then one week,3 weeks and 6 weeks after that...
October 5, 2017: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
https://www.readbyqxmd.com/read/29767319/endoscopic-vs-microscopic-transsphenoidal-surgery-for-cushing-s-disease-a-systematic-review-and-meta-analysis
#4
Leonie H A Broersen, Nienke R Biermasz, Wouter R van Furth, Friso de Vries, Marco J T Verstegen, Olaf M Dekkers, Alberto M Pereira
PURPOSE: Systematic review and meta-analysis comparing endoscopic and microscopic transsphenoidal surgery for Cushing's disease regarding surgical outcomes (remission, recurrence, and mortality) and complication rates. To stratify the results by tumor size. METHODS: Nine electronic databases were searched in February 2017 to identify potentially relevant articles. Cohort studies assessing surgical outcomes or complication rates after endoscopic or microscopic transsphenoidal surgery for Cushing's disease were eligible...
May 16, 2018: Pituitary
https://www.readbyqxmd.com/read/29749920/evolution-of-the-graded-repair-of-csf-leaks-and-skull-base-defects-in-endonasal-endoscopic-tumor-surgery-trends-in-repair-failure-and-meningitis-rates-in-509-patients
#5
Andrew Conger, Fan Zhao, Xiaowen Wang, Amalia Eisenberg, Chester Griffiths, Felice Esposito, Ricardo L Carrau, Garni Barkhoudarian, Daniel F Kelly
OBJECTIVE The authors previously described a graded approach to skull base repair following endonasal microscopic or endoscope-assisted tumor surgery. In this paper they review their experience with skull base reconstruction in the endoscopic era. METHODS A retrospective review of a single-institution endonasal endoscopic patient database (April 2010-April 2017) was undertaken. Intraoperative CSF leaks were graded based on size (grade 0 [no leak], 1, 2, or 3), and repair technique was documented across grades...
May 11, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29686164/-treatment-of-rathke-s-cleft-cyst-technical-note-for-preservation-of-pituitary-function
#6
Miiko Ito, Kenichiro Matsuda, Atsushi Kuge, Shinya Sato, Takamasa Kayama, Yukihiko Sonoda
Pituitary dysfunction, such as panhypopituitarism or diabetes insipidus(DI), is often found in patients with Rathke's cleft cyst. Patients were treated with transsphenoidal microscopic surgery; however, pituitary dysfunction did not usually recover. Recently, endoscopic transsphenoidal surgery(eTSS)has enabled minimally invasive surgery for patients with Rathke's cleft cyst. In this study, we analyzed 22 consecutive patients with Rathke's cleft cyst who underwent eTSS to determine if pituitary dysfunction recovered...
April 2018: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/29682011/endoscopic-versus-microscopic-pituitary-adenoma-surgery-an-institutional-experience
#7
Hanuman Prasad Prajapati, Shashi Kant Jain, Virendra D Sinha
Aim: The aim of this study was to compare the efficacy of endoscopic versus microscopic excision of pituitary adenoma, and to evaluate the merits and demerits of each approach. Materials and Methods: Prospective data were collected and patients were surgically treated for pituitary adenoma at SMS Hospital, Jaipur, Rajasthan, India. Patients consent was obtained. Age, sex, presenting symptoms, length of hospital stay, pre- and post-operative hormone status, extent of resections of tumors, and intra- and post-operative complication were noted...
April 2018: Asian Journal of Neurosurgery
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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...
May 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29288106/pituitary-apoplexy-should-endoscopic-surgery-be-the-gold-standard
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
Katharina Osterhage, Patrick Czorlich, Till R Burkhardt, Roman Rotermund, Ulrich Grzyska, Jörg Flitsch
OBJECTIVE: To identify symptomatic vasospasms as a rare complication after transsphenoidal surgery, with emphasis on management and outcomes. METHODS: In this retrospective study, the medical records of 1997 patients who underwent microscopic transsphenoidal surgery at our hospital between 2008 and 2016 were analyzed regarding postoperative vasospasm events, clinical management, and neurologic outcomes. RESULTS: Four patients (0.2%) were identified who developed neurologic deficits in the postoperative phase caused by proven vasospasms due to subarachnoid hemorrhage (SAH)...
February 2018: World Neurosurgery
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